UnitedHealth Group Under Investigation For Possible Medicare Fraud
UnitedHealth Group is being investigated for possible Medicare fraud, according to The Wall Street Journal, sending shares of the healthcare company sliding in after-hours trading just one day after its CEO, Andrew Witty, announced he was stepping down from his position.
UnitedHealthcare is owned by UnitedHealth Group. (Photo by PATRICK T. FALLON/AFP via Getty Images)
The Justice Department's healthcare-fraud unit is leading the probe, the Journal reported.
UnitedHealth's stock tanked around 7% following the Journal's report, bringing shares to their lowest point in almost five years.
This is a developing story. Check back for updates.
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Thanks to decades of compound investment growth, widespread homeownership, and rising asset values, seniors are no longer the systematically vulnerable group they once were. The top income quintile includes a growing number of retirees who draw substantial incomes from pensions and investment portfolios with Social Security benefits layered on top. These programs have become a transfer of wealth from the relatively poor to the relatively wealthy and old. Of course, America still has some poor seniors, so cutting across the board is bad. This is why the cuts should be targeted, not the automatic effects in 2033. And Congress should get started now. The size of the problem is staggering. Social Security's shortfall now equals 3.82 percent of taxable payroll or roughly 22 percent of scheduled benefit obligations. Avoiding insolvency eight years from now would require an immediate 27 percent benefit cut, according to former Social Security and Medicare trustee Charles Blahous. 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The cost of political giveaways is steep. Social Security's 75-year unfunded obligation has now reached $28 trillion, up from $25 trillion just a year ago. Medicare is no better. Its costs are projected to rise from 3.8 percent of gross domestic product today to 6.7 percent by the end of the century (8.8 percent under more realistic assumptions). Most of the additional spending will be financed through general revenue, meaning more borrowing and more pressure on the federal budget. As Romina Boccia of the Cato Institute has documented, other countries have taken meaningful steps to address similar challenges. Sweden and Germany implemented automatic stabilizers that slow benefit growth or raise taxes when their systems become unsustainable. New Zealand and Canada have moved toward more modest, poverty-focused pension systems that offer basic support without bankrupting the state. A few weeks ago, Denmark increased the retirement age to 70. These are serious reforms. 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Across Illinois, millions of people are anxiously awaiting the next move on a bill that would cut hundreds of billions of dollars from Medicaid across the country. The 'One Big Beautiful Bill Act' would slash the program, which provides health care coverage to people with low incomes, in order to help pay for tax cuts and border and national security. President Donald Trump and congressional Republicans say the bill would cut waste, fraud and abuse from Medicaid, providing coverage only to those who truly need it. But Democrats, health care leaders and patients say it would devastate those who rely on the program, and the hospitals that serve all patients. Across Illinois, 3.4 million people are on Medicaid — about one-fourth of the state's population. Depending on which proposals are adopted, Illinois could lose billions of dollars — a loss that could force the state to make difficult decisions about who gets coverage and what kind of coverage they get. 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House and Senate versions of the bill have included provisions that could make it more difficult for people who are enrolled in both Medicare and Medicaid to keep their Medicaid coverage, according to KFF. Lewis is also one of millions of people in Illinois who may end up dealing with the fallout of Illinois receiving fewer federal dollars overall, if certain proposals become law. Both the House and Senate have proposed changes that could limit the amount of money Illinois and many other states collect in so-called provider taxes, which help boost the amount of money states receive from the federal government for Medicaid. Proponents of provider taxes say they're a necessary way of funding Medicaid, while critics say provider taxes are a way for states to inflate how much money they receive from the federal government. Republican Rep. Chip Roy of Texas recently called provider taxes a 'Medicaid money laundering scam.' 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'Exactly what benefits are cut, what provider rates are cut, what eligibility will be cut remains to be seen, but it will be across Medicaid.' Lewis is worried about any kind of reduction to her Medicaid benefits. She said she first got on Medicaid about 10 to 15 years ago when she was living in a nursing home because of health issues. Eventually, her health improved to the point where she could live independently. She worries that if her health issues again become unmanageable, she might have to one day return to living in a nursing home. 'I would really, really struggle,' she said of if her Medicaid benefits were cut. 'My biggest fear is to end up in another nursing home. You lose your independence.' If she did have to live in a nursing home again, Medicaid may end up footing the substantial bill. In Illinois, Medicaid pays for about 68% of all nursing home care, according to the state Department of Healthcare and Family Services. Cornelia Simms, 60, of Auburn Gresham, fears work requirements could make it difficult for her to stay on Medicaid — even though she has a job. Under the bill, childless, able-bodied adults ages 19 to 64 would be required to spend at least 80 hours a month working, doing community service or going to school, in order to stay on Medicaid. Simms already works about 80 hours a month as a home health care aide — a profession she got into after spending years caring for her ailing mother. She discovered that she enjoys helping elderly people and stuck with it after her mom passed away. About 70% of Illinois residents on Medicaid already work, according to KFF. But Simms worries about the paperwork, and the potential problems it could create if she's subject to work requirements. The bill would require states to verify at least twice a year that Medicaid beneficiaries are meeting work requirements. Simms is concerned about being asked to prove that she's eligible twice a year, especially because she said she prefers to verify her eligibility in person, which can require time away from work. It can be tough for her to take days off from work because the person she cares for relies on her help, Simms said. 'I'm mainly her sole person to take her to the hospital, grocery stores and do all those things with her,' Simms said. 'If I have to take off work to see about my Medicaid then she will be lacking the daily things that she needs.' The extra paperwork can also create administrative complications. Once, Simms said she forgot to submit paperwork to verify her continued eligibility for Medicaid. Simms lost her coverage, and it took more than six months to get it back, she said. During that time, she canceled doctor appointments and generally tried not to get medical care. 'I tried not to catch a cold,' Simms said. 'I just prayed and held out.' 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The 61-year-old West Pullman man relies on Medicaid to pay for his doctors' visits and the medications that 'keep me above water.' Rogers is now worried about losing that lifeline. A recent version of the bill proposed work requirements not only for childless able-bodied Medicaid recipients, but also for adults with children older than 14. Rogers' son is 12. The single father is concerned that there might come a point when he would be subject to the proposed requirement to work 80 hours a week or lose his Medicaid coverage. Between his health issues and caring for his son, as well as his lack of a high school diploma, Rogers doesn't think it would be possible for him get a job working 80 hours a month. Rogers drops his son off and picks him up from school each day, taking city buses with him to and from the school. He doesn't envision letting his son take the buses himself. 'At 14, no, not in Chicago,' Rogers said of his son taking the bus alone. 'People who don't ride the bus and don't live in our 'hood, they don't know what's going on. I'm not going to subject my son to that danger.' He knows the dangers all too well. Rogers was incarcerated when he was younger, saying he was once a 'destroyer' of his community. He's since tried to turn his life around, working with Community Organizing and Family Issues to create positive change. But his life now, as he knows it, depends on having Medicaid. He's confident he'll lose Medicaid if he's required to work 80 hours a month. He worries that if he loses Medicaid, he'll no longer be able to afford insulin and his other medications, and he may slip into a diabetic coma or suffer a stroke. 'Having Medicaid keeps me alive,' Rogers said. 'It keeps me going, with the consistent doctors appointments, with the different types of medications. 'Having Medicaid helps me stay healthy to let me take care of my son,' Rogers said.
