The Department of Justice (DOJ) is reportedly investigating healthcare company UnitedHealth and its services division, Optum, for potential anti-trust violations, as reported by the Wall Street Journal. Over the recent weeks, investigators have been engaging healthcare industry representatives in order to learn about UnitedHealth's relationship with Optum. This services division, which UnitedHealth acquired in 2011, contracts with over 90,000 doctors to provide a range of healthcare solutions.
Optum offers services not just to UnitedHealth but also, quite notably, to its competitors. There are concerns about whether the practices of the company in terms of Medicare billing are pressuring doctors into exaggerating the severity of their patients' conditions, potentially leading to unjustified increases in governmental payments. The DOJ is also scrutinizing the company's planned acquisition of home-health provider Amedisys, which is valued at $3.3 billion.
Harking back to 2022, federal data indicates that Americans were spending approximately $13,493 per capita on healthcare services. Under the Biden administration, the first-ever drug pricing legislation in the U.S., the Inflation Reduction Act, was enacted last year. Investigations also began into the business activities of pharmacy benefit manager middlemen. Similarly, scrutiny is now extending towards the involvement of entities like CVS's Caremark and Cigna's Express Scripts, as lawmakers try to understand their role in the increasing costs of healthcare. This is part of the broader effort by the Biden administration to decrease Medicare expenses.
