January 12, 2026
Finance

UnitedHealth Group Faces Senate Scrutiny Over Medicare Advantage Coding Practices

Investigation Reveals Aggressive Diagnosis Collection Tactics Tied to Increased Federal Medicare Payments

Summary

UnitedHealth Group is currently under investigation by the Senate Judiciary Committee for its use of assertive methods to secure diagnoses that led to increased federal Medicare Advantage payments. The inquiry examines internal practices such as incentivizing additional diagnoses and employing AI-driven data analysis to adjust payment claims. Despite UnitedHealth asserting compliance and cooperation with federal authorities, the revelations have prompted renewed focus on Medicare Advantage payment structures and insurer conduct.

Key Points

The Senate Judiciary Committee is investigating UnitedHealth Group for aggressive diagnosis coding practices that increased Medicare Advantage payments.
UnitedHealth has pledged full cooperation with federal authorities and confidence in its compliance with Medicare rules.
The investigation revealed internal practices including financial incentives for physicians and AI-driven data analysis to identify add-on diagnoses.
UnitedHealth's adjustments to diagnosis coding policies contributed to weaker financial results and a decline in its stock price in spring 2025.

Recent developments have brought UnitedHealth Group Inc. (NYSE: UNH) under intensified examination by a Senate Judiciary Committee investigation. The probe, which commenced over a year ago, scrutinizes the company’s tactics in aggregating diagnoses that enhance federal Medicare Advantage reimbursements.

In July 2025, UnitedHealth publicly acknowledged initiating full compliance with formal criminal and civil information requests issued by the Department overseeing the case. While the insurer affirms confidence in its methodologies, it has committed to maintaining cooperative engagement with the Department throughout the investigation.

The renewed attention to UnitedHealth's operations has been fueled by accounts from several former employees now providing information to federal investigators. Information obtained by the Senate Committee includes an extensive review of approximately 50,000 pages of documents submitted by UnitedHealth last year at the behest of Senator Chuck Grassley.

The backdrop of this inquiry involves the Medicare Advantage program, wherein insurers receive fixed payments to manage healthcare coverage for seniors and individuals with disabilities. These payments are adjusted based on patient diagnoses, with higher payments allocated when more costly medical conditions are documented. Investigators report that UnitedHealth allegedly exploited this adjustment system, transforming it into a significant revenue driver that, according to findings, may surpass the original program intentions.

According to a Senate report, UnitedHealth's internal strategies included proactive deployment of nurses for in-home patient visits, financial incentives designed to encourage physicians to document additional diagnoses, and the application of artificial intelligence alongside data-mining technologies to comb through medical records for unrecorded conditions.

Documents reviewed include internal training materials, diagnostic guidelines, manuals, and studies outlining the company's practices. Some guidelines reportedly promoted recording diagnoses linked to increased payments without always adhering to recommended confirmatory testing protocols.

The Wall Street Journal previously raised concerns during a 2024 investigation, alleging that UnitedHealth systematically added diagnoses generating billions in extra federal reimbursements, with some conditions being questionable or lacking sufficient patient treatment. UnitedHealth has countered these allegations, emphasizing adherence to Medicare rules and positive outcomes in audits scrutinizing their diagnosis coding.

Highlighting the financial impact, UnitedHealth admitted that changes in policies concerning diagnosis recording contributed to weaker financial performance in the spring of 2025, which corresponded with a notable decline in the company’s share price.

In December 2025, UnitedHealth released preliminary results from a comprehensive independent review of its business operations, describing this initiative as part of a broader effort to enhance transparency and foster operational reforms under recently established leadership.

In addition to Medicare Advantage-related scrutiny, UnitedHealth has faced regulatory questions about other practices. In August 2025, two Democratic senators requested information regarding emergency relief loans the company extended to healthcare providers following a February 2024 cyberattack, which compromised the data of approximately 190 million Americans and impacted numerous healthcare entities including doctors, pharmacies, hospitals, and laboratories. The inquiry also explored how UnitedHealth is managing the recovery of these loaned funds.

Furthermore, in March 2025, UnitedHealth’s pharmacy benefits manager, Optum Rx, announced plans to adjust its payment models to more accurately align with cost fluctuations faced by pharmacies due to manufacturer pricing changes. Full implementation of these adjustments is targeted for January 2028.

According to Benzinga Pro data at the time of publication, UnitedHealth Group shares declined 2.51%, trading at $335.35 on Monday, reflecting the market’s reaction to the unfolding developments.

Risks
  • Potential federal legal and regulatory consequences stemming from the ongoing investigation into diagnosis coding.
  • Financial risks linked to reputational damage and increased scrutiny impacting UnitedHealth's stock performance.
  • Operational challenges related to implementing transparency and policy reforms following the independent review.
  • Uncertainty surrounding repayment and management of emergency loans extended after the 2024 cyberattack.
Disclosure
Education only / not financial advice
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