Billing or Healing? UnitedHealth's HouseCalls Get a DOJ Checkup

Core Insights - UnitedHealth Group Incorporated (UNH) is under investigation by the U.S. Department of Justice regarding its Medicare Advantage billing practices, specifically for potentially inflating diagnoses to receive higher payments from Medicare [1][3][8] - The investigation focuses on the HouseCalls program, where nurses visited patients at home and allegedly recorded diagnoses that led to additional payments, raising concerns about healthcare fraud [2][3] - As the largest player in the Medicare Advantage market, a criminal probe could have significant implications for UnitedHealth, including billions in federal payments and its overall business model [3][4] Company Performance - UnitedHealth has denied any wrongdoing, asserting that its practices comply with federal guidelines, but faces challenges amid rising medical costs and has withdrawn its 2025 earnings guidance [4][8] - The stock of UnitedHealth has declined by 40.2% year-to-date, compared to a 31.1% decline in the industry [7] - The Zacks Consensus Estimate for UnitedHealth's 2025 earnings is projected at $21.85 per share, indicating a 21% decrease from the previous year [11] Industry Context - Other insurers, such as Molina Healthcare and Centene Corporation, are also struggling with rising medical costs, leading to reduced earnings guidance and financial outlooks [5][6] - Molina Healthcare has adjusted its 2025 earnings per share forecast down to between $21.50 and $22.50, while Centene Corporation has pulled its financial outlook due to higher medical costs [5][6]