Justice Department begins antitrust investigation into UnitedHealth

The Justice Department has begun an antitrust investigation into UnitedHealth Group, The Wall Street Journal reported Feb. 27.

Justice Department investigators have been interviewing healthcare industry representatives in UnitedHealth competition sectors in recent weeks, which includes physician groups, the publication reported.

Investigator questions during the interviews have included specific relationships between the company's UnitedHealthcare insurance unit along with its Optum health-services arm, which owns physician groups along with additional assets.

Possible impacts of UnitedHealth's physician group acquisitions pertaining to rivals and consumers have also been addressed during the questioning. 

The inquiry is, in part, looking into Optum's physician group acquisitions and how the physician and health plan unit ownerships affect competition. Investigators have asked if UnitedHealthcare favored Optum-owned groups in its contract pricing, which could remove rival physicians from specific attractive payment arrangements.

Another area of interest for investigators is if Optum's healthcare provider ownerships might present challenges to UnitedHealthcare's rival health insurers. The Justice Department is also looking into Medicare billing issues, including UnitedHealth Group's patient illness documentation practices, The Wall Street Journal said.

News of the investigation comes as President Joe Biden's administration's antitrust enforcers have heightened investigations into some of the country's largest companies, like Apple and Amazon. 

The Biden administration has shared that the healthcare industry is an important piece of the puzzle in its antitrust efforts.

UnitedHealth Group mergers and acquisitions are no stranger to challenges from the Justice Department.

Most recently, Optum faced scrutiny from the Justice Department over its proposed $3.29 billion acquisition of Amedisys, a home health provider, after Amedisys received a request from the Justice Department that asked for additional information regarding the merger. The proposed merger also faced backlash from lawmakers.

In September 2022, a Washington, D.C., federal judge rejected the Justice Department's lawsuit attempting to stop UnitedHealth Group from acquiring Change Healthcare for $7.8 billion.

Apart from the Justice Department's inquiries, Covina, Calif.-based Emanate Health has also filed a lawsuit against UnitedHealth Group's Optum last November accusing it of anticompetitive practices, along with a "concerted effort to prevent patients from contacting their doctors who chose to leave [Optum] to join competing medical groups."

Becker's has reached out to UnitedHealth Group and the Justice Department for comment regarding the investigation and will update this story as more information becomes available. 

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