DOJ investigates UnitedHealth Group over antitrust concerns amid rising healthcare costs. (Reuters)
The United States Department of Justice (DOJ) has initiated an antitrust inquiry into UnitedHealth Group, as per a report by the Wall Street Journal on Tuesday, quoting sources familiar with the matter.
In recent weeks, investigators have been speaking with representatives from the healthcare industry, particularly those sectors where UnitedHealth is a player, such as doctor groups, according to the report.
During these discussions, investigators have been probing various aspects, including specific relationships between UnitedHealthcare, the company's insurance arm, and Optum, its health services division, which owns physician groups and other assets.
Optum Health, a segment of UnitedHealth, provides a variety of healthcare services, ranging from pharmacy benefit management to financial consultation and mental health support.
The United States is grappling with escalating healthcare expenses, with per capita healthcare spending estimated to be around $13,493 in 2022, according to federal data released late last year.
The Biden administration has prioritized reducing drug prices, passing the first-ever US drug pricing legislation in the Inflation Reduction Act last year. It has since turned its attention to pharmacy benefit manager intermediaries.
Lawmakers and the Federal Trade Commission have been investigating the role of these intermediaries in the rising costs of healthcare. Several bills have been in the works since last year, aiming to compel them to disclose their business dealings, including the fees they earn on transactions.
The Wall Street Journal also reported that the DOJ is scrutinizing the company's Medicare billing practices to determine whether doctors are overemphasizing their patients' illnesses to inappropriately increase payments from the government.
Investigators are also inquiring about the potential effects of the company's acquisitions of doctor groups on competitors and consumers, as per the Wall Street Journal report, citing sources.
UnitedHealth also competes with CVS Health and Cigna, which provide health insurance plans and pharmacy benefit management (PBM) services.
The DOJ had previously filed a lawsuit to block UnitedHealth Group's acquisition of Change Healthcare in February 2022, but the acquisition was completed later that year.
A cyberattack on billing and data systems provider Change Healthcare has caused disruptions across healthcare businesses in the United States since last week.
The DOJ declined to comment, while UnitedHealth did not immediately respond to a Reuters request for comment.
The company's shares fell by 2.3%.
On Monday, Examiner Media reported, citing an internal email, that UnitedHealth had received a notice from the DOJ in October last year, indicating that it had initiated a "non-public antitrust investigation into the company."
