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Jan 12, 2026 12:00 PM

Senate Report Raises Questions Over UnitedHealth's Use Of Medicare Diagnoses

A Senate Judiciary Committee investigation found that UnitedHealth Group Inc. (NYSE:UNH) used aggressive strategies to collect diagnoses that increased federal payments under Medicare Advantage.

In July 2025, the company said it had begun complying with the Department’s formal criminal and civil requests. UnitedHealth says it has full confidence in its practices and is committed to working cooperatively with the Department throughout this process.

The probe began at least a year ago and is now drawing fresh scrutiny as former employees speak with federal investigators.

How Medicare Advantage Payments Work

The Wall Street Journal on Monday reported that Medicare Advantage pays insurers a fixed amount to manage care for seniors and people with disabilities, with higher payments tied to patients diagnosed with costly medical conditions.

According to the Senate report, UnitedHealth transformed that payment adjustment process into a profit driver, a use that investigators said went beyond the program’s original intent.

The findings stem from a review of roughly ...