Justice Department Launches UnitedHealth Antitrust Investigation

An antitrust investigation launched by the Justice Department scrutinizes UnitedHealth’s ownership of the largest US health care insurer and its extensive network of health care assets, including doctor groups and drug benefits.

In recent weeks, investigators at the Wall Street Journal interviewed health care industry representatives in sectors where UnitedHealth competes, including doctor groups. Investigators reportedly are questioning relationships between the company’s UnitedHealthcare insurance unit, and its Optum health-services arm and the company’s doctor-group acquisitions. 

“UnitedHealth executives have said Optum and UnitedHealthcare don’t favor one another, and routinely work with competitors,” reported the Wall Street Journal. 
The investigation results from the Biden administration’s recent prioritization of law enforcement for monopolies, specifically within the health care industry. The Justice Department has previously challenged UnitedHealth over various acquisitions, such as a federally denied challenge to Optum’s health-technology firm Change Healthcare acquisition in 2022.  

The Justice Department also prompted UnitedHealth to provide information in August 2023 about a planned acquisition of home-health company Amedisys for about $3.3 billion. 

“UnitedHealth is also facing a private antitrust suit by a California hospital system called Emanate Health, alleging that the company tried to strong-arm the nonprofit over its affiliated physician groups and exert control over primary-care doctors in its region,” reported the Wall Street Journal. 

The Justice Department’s ongoing investigation seeks to discern if UnitedHealthcare favored Optum-owned groups in contracting, potentially disadvantaging other physicians. They are also exploring challenges Optum's ownership may pose to health insurers competing with UnitedHealthcare and Medicare billing issues. Concerns were raised about the tie-up affecting compliance with federal rules on how much health insurance companies can retain from premiums collected.

Reference

Mathews AW, Michaels D. U.S. Opens UnitedHealth antitrust probe. WSJ. Updated February 27, 2024. Accessed March 5, 2024. www.wsj.com/health/healthcare/u-s-launches-antitrust-investigation-of-healthcare-giant-unitedhealth-ff5a00d2