UnitedHealth

UnitedHealth Group (UNH) on Friday refuted claims by The Wall Street Journal that the US Department of Justice had launched an investigation into the health insurer’s Medicare billing practices. The Journal reported Friday, citing sources, that the DOJ was looking into UnitedHealth’s protocol for recording diagnoses that prompt additional payments to its Medicare Advantage, or MA, plans. The Journal said that the new civil fraud investigation was launched in recent months. Prior WSJ reports show that Medicare paid the company “billions of dollars” for dubious diagnoses, according to the latest report by the Journal. The Department of Health and Human Services’ Office of Inspector General is also involved in the latest probe, the Journal reported Friday. UnitedHealth’s shares were down 8.9% in afternoon trade. “We are not aware of the ‘launch’ of any ‘new’ activity as reported by the Journal,” the company said in a statement. “Any suggestion that our […]

UnitedHealth Group stock tumbled in premarket trading Friday following a report that said the Justice Department had launched a civil fraud investigation into the company’s Medicare billing practices. The stock fell 8.8% to $458 in premarket trading. The DOJ probe aims to examine the healthcare company’s practices for documenting diagnoses that trigger extra payments to its Medicare Advantage plans, The Wall Street Journal reported, citing people familiar with the matter. Under the current system, the federal government pays insurers a fixed amount each month to oversee enrollees’ Medicare benefits. These payments can increase when patients have certain diagnoses. An official Medicare booklet notes that each Medicare Advantage plan “can charge different out-of-pocket costs and have different rules for how you get services.” Barron’s has reached out to the Justice Department and UnitedHealth for comment. News of the investigation comes months after the DOJ moved to block UnitedHealth’s acquisition of home

UnitedHealth Group is scheduled to report its financial results on Thursday, a month and a half after the killing of the head of its health insurance division. Recent months have raised other challenges for UnitedHealth, which is the largest healthcare company in the country, and has operations that touch virtually every corner of the healthcare system. It owns an insurer, a pharmacy benefit manager, a key software provider, and physician practices, among other businesses. In mid-December, President-elect Donald Trump threatened to “knock out” pharmacy-benefit managers from their role as middlemen in the drug market, a risk for UnitedHealth because its OptumRx is among the largest such companies. The healthcare news website STAT reported in late December that a number of Democratic U.S. senators were calling for a potential breakup of UnitedHealth. The advent of the Trump administration could bring other changes. Investors are anticipating a friendlier atmosphere for Medicare Advantage,

UnitedHealth Group (UNH) shareholders have proposed that the health insurance company report on “public health-related costs and macroeconomic risks” caused by practices that “limit or delay access to healthcare.” The shareholder proposal said the report should evaluate how the company’s practices “impact access to healthcare and patient outcomes.” It said the report should include how often authorization requirements or denials of coverage have led to a delay or abandonment of medical treatment, as well as serious adverse events for patients as a result. “UNH has been in the media and legislative spotlight for some time given its market dominance, aggressive marketing of Medicare Advantage and questionable use of AI algorithms to deny care to patients,” said Timnit Ghermay of the Sisters of the Holy Names of Jesus and Mary. “Our proposal suggests some introspection by UNH that will help the company and all its stakeholders thrive.”

UnitedHealth Group (UNH) is seeing a steeper-than-expected medical cost trend amid elevated Medicare coding intensity and temporary Medicaid acuity headwinds, RBC Capital Markets said in a note Wednesday. RBC said it is raising its 2025 Medical Care Ratio estimate by 70 basis points to 84.7% and lowering its adjusted earnings per share estimate to $29.75 from $30.84 previously. “Our estimate reflects elevated Medicare coding intensity, which has persisted beyond resumption prior authorization, as well as Medicaid acuity headwinds, which should be transitory,” RBC analysts said in the note. UnitedHealth’s management cited three headwinds, including an about 20% rise in Medicare coding intensity, elevated Medicaid acuity from timing mismatches, and increased specialty drug prescribing, RBC said, adding that these specialty headwinds should not affect the medical cost ratio beyond Q4 as the company has priced for Inflation Reduction Act drug provisions in its 2025 bids. RBC reiterated its outperform rating on

UnitedHealth Group’s 2025 earnings guidance came in below analyst forecasts, weighing on its shares as the healthcare heavyweight deals with a variety of factors that are hurting profitability. The company says recent Medicaid redeterminations have left it with fewer, but sicker, members, while funding from Medicare has declined despite elevated hospital spending, Mizuho analyst Ann Hynes says in a research note. There has also been an increase in the utilization of expensive specialty drugs, the analyst says. UnitedHealth says it expects to continue facing these cost pressures as certain care patterns persist at higher levels than previously expected, the analyst says. Shares fall 7% to $562.48.

CFRA, an independent research provider, has provided MT Newswires with the following research alert. Analysts at CFRA have summarized their opinion as follows: Shares jumped on UNH’s report of relatively mild financial impacts, in our view, from the Q1 cyberattack. We raise our 12-month target $18 to $515, 18.7x our 2024 EPS estimate (down $0.09 to $27.53), a premium to peers but below UNH’s recent historical average. We lower our 2025 EPS estimate by $0.10 to $31.10. UNH reported Q1 adjusted EPS of $6.91 vs. $6.26, beating consensus by $0.29, supported by Optum revenue growing 12.9% Y/Y on patient growth and higher Rx volumes. Optum segment adjusted operating margin declined to 6.4% from 6.9% in Q1 2023 given business disruption to OptumInsight. UNH indicated a $0.74 EPS hit from the cyberattack during the quarter and expects a full-year impact of $1.15-$1.35. Facing weaker Medicare reimbursement and the cyber incident, MCR

The following is a summary of the UnitedHealth Group Incorporated (UNH) Q1 2024 Earnings Call Transcript: Financial Performance: United Health Group reported Q1 2024 revenues of $75.4 billion, indicating an increase of nearly $5 billion. Medical care ratio for the first quarter was 84.3%. Despite the business disruption impacts related to Change Healthcare’s cyber attack which led to an estimated financial hit of $1.15 to $1.35 per share, full-year adjusted earnings per share are expected to be in the range of $27.50 to $28.00. Business Progress: UnitedHealthcare added 2.1 million new consumers in Q1, sustaining robust growth. Revenues for Optum Health and Optum Rx increased by 16% and 12% to $26.7 billion and $30.8 billion respectively, expanding services further and strengthening existing partnerships. UnitedHealth Group is taking measures to recover and mitigate the impacts of the cyber attack, including restoring system functionality and providing financial support to impacted clients. The

UnitedHealth Group (UNH) shares rose 5.3% in recent Tuesday trading after Q1 profit and revenue topped estimates by analysts, and the company affirmed its 2024 adjusted earnings outlook despite disruptions from a cyberattack. Earlier Tuesday, the company reported Q1 adjusted earnings of $6.91 a share, up from $6.26 a year earlier. Analysts polled by Capital IQ expected $6.62. Revenue in the quarter ended March 31 rose to $99.8 billion from $91.93 billion a year earlier. Analysts surveyed by Capital IQ expected $99.28 billion. The company said it continues to expect full-year 2024 adjusted EPS of $27.50 to $28. Analysts expect $27.53. UnitedHealth said it booked $872 million in costs in Q1 due to the Change Healthcare cyberattack, which is expected to cost $1.35 billion to $1.6 billion in the year ending Dec. 31. Chief Executive Officer Andrew Philip Witty said on an earnings call that UnitedHealth’s “substantial resources” helped mitigate

UnitedHealth Group Reports First Quarter 2024 Results — Revenues of $99.8 Billion Grew Nearly $8 Billion Year Over Year — Earnings Reflect $0.74 per Share of Impacts from Change Healthcare Cyberattack; $0.49 to Support Direct Response Efforts and $0.25 in Business Disruption Impacts — Company has Provided Over $6 Billion in Advance Funding and Interest-Free Loans to Support Care Providers in Need — First Quarter Net Loss of $1.53 Per Share is Due Primarily to Currency Effects of Previously Reported Brazil Sale and the Cyberattack — Adjusted Earnings of $6.91 Per Share Include the $0.25 in Business Disruption Impacts but Exclude Brazil Sale and Direct Response Costs UnitedHealth Group (NYSE: UNH) reported first quarter 2024 results reflecting broad-based growth at Optum and UnitedHealthcare, medical care activity consistent with expectations and the impact of the recent cyberattack on Change Healthcare. This press release features multimedia. View the full release here: UnitedHealth

UnitedHealth Sees Full-Year 2024 Cyberattack Impacts of $1.15-$1.35/Share.

UNITEDHEALTH GROUP Sees Fiscal Year 2024 EPS Range $27.50 – $28.00.