A Senate Judiciary Committee investigation, based on a review of over 50,000 pages of internal documents, has raised concerns about UnitedHealth Group’s strategies to maximize Medicare Advantage reimbursements. According to the report, the company deployed nurses for in-home chart reviews, offered financial incentives to physicians for submitting additional diagnoses, and utilized proprietary AI tools to scan electronic medical records for unconfirmed conditions. The probe indicates these tactics may have inflated risk scores, boosting federal payments by millions of dollars. UnitedHealth disputes any wrongdoing and asserts that its processes comply with Medicare regulations. Following publication of the report, the company’s share price fell by 2.5% during Monday trading, reflecting investor concerns over potential regulatory scrutiny and financial liabilities.

UnitedHealth Group released two independent actuarial studies conducted by Milliman, estimating 2025 costs for Medicare Advantage (MA) versus traditional Medicare. The findings show that MA plans cost the federal government 9% less—approximately $1,117 per member per month versus $1,234—translating into over $1,400 in annual savings per enrollee. These savings fund supplemental benefits such as dental, vision and hearing coverage, delivering an estimated $63 billion in additional annual value to beneficiaries. The analysis incorporates the phase-in of CMS’s V28 risk adjustment model, which trimmed MA revenue by 4% compared to the prior V24 model. Separately, Milliman found that a non-dual eligible aged-in MA-PD beneficiary will spend 53% less out-of-pocket in 2025—$3,651 versus $7,790—thanks to annual out-of-pocket maximums and inclusion of supplemental benefits at minimal extra cost. With over 34 million Americans enrolled in MA, UnitedHealth emphasizes these results as evidence of its commitment to cost efficiency and improved patient outcomes.