Core Viewpoint - UnitedHealth Group is currently under investigation by the Department of Justice for potential civil fraud related to its Medicare Advantage plans, which has led to a decline in its stock price [1][2][4]. Group 1: Investigation Details - The investigation focuses on how UnitedHealth records diagnoses that result in additional payments for its Medicare Advantage plans [2][7]. - A federal criminal health care-fraud unit is examining the company's practices involving doctors and nurses in gathering diagnoses to enhance payments [4]. - UnitedHealth has stated it is cooperating with federal investigators and has a history of responsible conduct and compliance [1][4]. Group 2: Business Overview - UnitedHealth's UnitedHealthcare division is the largest provider of Medicare Advantage plans, covering over 8 million individuals [3][4]. - The company generated more than $400 billion in revenue last year, ranking as the third-largest company in the Fortune 500 [5]. - The company also operates a growing Optum business that provides care and technology support [5]. Group 3: Stock Performance - UnitedHealth's stock price has decreased significantly, dropping 54% from its all-time high of over $630, with a recent price of $287.39 [5][8]. - The decline in stock value has been exacerbated by a spike in healthcare usage and a subsequent cut in the company's forecast earlier this year [8]. - The company is set to report its second-quarter results next Tuesday, which may further impact stock performance [8].

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asserting that its practices comply with federal guidelines, but faces challenges amid rising medical costs and has withdrawn its 2025 earnings guidance [4][8] - The stock of UnitedHealth has declined by 40.2% year-to-date, compared to a 31.1% decline in the industry [7] - The Zacks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]