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UnitedHealth Group CEO Stephen Hemsley arrives to testify before a House committee on January 22, 2026.
"Most of the perpetrators are lodged within large corporations run by white executives with excellent and expensive legal representation," wrote one journalist.
US President Donald Trump has used unsubstantiated allegations of large-scale fraud in Minnesota's Somali community as a pretext to surge federal agents into the state—with deadly consequences—and cut off federal childcare funding.
But unlike the Somali community, which Trump has subjected to grotesque attacks that have left many fearing for their safety, Minnesota-based UnitedHealth Group (UHG) has not faced the president's public ire.
One of the nation's largest for-profit health insurance companies, UHG is the leading beneficiary of a long-running Medicare Advantage fraud scheme that could cost US taxpayers $1.2 trillion over the next decade—a sum that dwarfs even the White House's wildest claims about the costs of fraud allegedly committed by Somali-run daycares.
The $1.2 trillion estimate comes from a report published earlier this month by the Medicare Payment Advisory Commission (MedPAC), which found that federal overpayments to privately run, publicly funded Medicare Advantage plans will total around $76 billion this year in part due to a practice known as upcoding, whereby insurers present patients as sicker than they actually are to reap larger payments.
UnitedHealthcare, UHG's insurance division, is the leading Medicare Advantage provider in the United States. Stephen Hemsley, UnitedHealth Group's CEO, received a base salary of $1 million last year and a one-time equity award worth $60 million.
ICE/CBP swarms into Minnesota to crack down on government fraud. Somehow they sidestep the orders-of-magnitude higher government fraud by Minnesota-based UnitedHealth, who leads a Medicare Advantage fraud that government analyst MedPac estimates as costing America $76 billion/yr pic.twitter.com/dECnwgUCRV
— David Dayen (@ddayen) January 27, 2026
A Senate report released on January 12 found that UnitedHealth Group uses "aggressive strategies" to maximize patients' so-called "risk-adjustment scores" in an effort to receive larger Medicare Advantage payments from the federal government.
"UHG has turned risk adjustment into a major profit-centered strategy, which was not the original intent of the program," states the report, which was based on more than 50,000 pages of company documents obtained by the Senate Judiciary Committee.
The Senate report cited a 2024 Wall Street Journal investigation showing that "insurer-driven diagnoses by UnitedHealth for diseases that no doctor treated generated $8.7 billion in 2021 payments to the company... UnitedHealth’s net income that year was about $17 billion."
"A real crackdown on fraud would go after those big fish first."
While the US Justice Department—headed by former corporate lobbyist Pam Bondi—is currently investigating UnitedHealth Group over its Medicare billing practices, the Trump administration has enabled the conglomerate's continued expansion and abuses.
Last August, the DOJ settled a Biden-era legal challenge aimed at preventing UnitedHealth Group from absorbing yet another competitor. According to a tracker run by the American Economic Liberties Project, the corporation is still denying necessary care to patients, overbilling the federal government, and engaging in anticompetitive behavior on the Trump administration's watch.
Journalist Merrill Goozner wrote last week that "there is no doubt greedy operators ripped off Minnesota safety net programs," observing that "several of the nearly 100 people under investigation have already pleaded guilty."
"But if federal officials in Minnesota really want to go after industrial-scale fraud, they ought to step up their slow-motion investigation of UnitedHealth Group," Goozner wrote. "The nation’s tattered social safety net, under assault by the Trump administration and shrinking daily, remains prone to abuse by unscrupulous operators. Medicare and Medicaid are especially juicy targets. Most of the perpetrators are lodged within large corporations run by white executives with excellent and expensive legal representation."
"A real crackdown on fraud," he added, "would go after those big fish first."
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US President Donald Trump has used unsubstantiated allegations of large-scale fraud in Minnesota's Somali community as a pretext to surge federal agents into the state—with deadly consequences—and cut off federal childcare funding.
But unlike the Somali community, which Trump has subjected to grotesque attacks that have left many fearing for their safety, Minnesota-based UnitedHealth Group (UHG) has not faced the president's public ire.
One of the nation's largest for-profit health insurance companies, UHG is the leading beneficiary of a long-running Medicare Advantage fraud scheme that could cost US taxpayers $1.2 trillion over the next decade—a sum that dwarfs even the White House's wildest claims about the costs of fraud allegedly committed by Somali-run daycares.
The $1.2 trillion estimate comes from a report published earlier this month by the Medicare Payment Advisory Commission (MedPAC), which found that federal overpayments to privately run, publicly funded Medicare Advantage plans will total around $76 billion this year in part due to a practice known as upcoding, whereby insurers present patients as sicker than they actually are to reap larger payments.
UnitedHealthcare, UHG's insurance division, is the leading Medicare Advantage provider in the United States. Stephen Hemsley, UnitedHealth Group's CEO, received a base salary of $1 million last year and a one-time equity award worth $60 million.
ICE/CBP swarms into Minnesota to crack down on government fraud. Somehow they sidestep the orders-of-magnitude higher government fraud by Minnesota-based UnitedHealth, who leads a Medicare Advantage fraud that government analyst MedPac estimates as costing America $76 billion/yr pic.twitter.com/dECnwgUCRV
— David Dayen (@ddayen) January 27, 2026
A Senate report released on January 12 found that UnitedHealth Group uses "aggressive strategies" to maximize patients' so-called "risk-adjustment scores" in an effort to receive larger Medicare Advantage payments from the federal government.
"UHG has turned risk adjustment into a major profit-centered strategy, which was not the original intent of the program," states the report, which was based on more than 50,000 pages of company documents obtained by the Senate Judiciary Committee.
The Senate report cited a 2024 Wall Street Journal investigation showing that "insurer-driven diagnoses by UnitedHealth for diseases that no doctor treated generated $8.7 billion in 2021 payments to the company... UnitedHealth’s net income that year was about $17 billion."
"A real crackdown on fraud would go after those big fish first."
While the US Justice Department—headed by former corporate lobbyist Pam Bondi—is currently investigating UnitedHealth Group over its Medicare billing practices, the Trump administration has enabled the conglomerate's continued expansion and abuses.
Last August, the DOJ settled a Biden-era legal challenge aimed at preventing UnitedHealth Group from absorbing yet another competitor. According to a tracker run by the American Economic Liberties Project, the corporation is still denying necessary care to patients, overbilling the federal government, and engaging in anticompetitive behavior on the Trump administration's watch.
Journalist Merrill Goozner wrote last week that "there is no doubt greedy operators ripped off Minnesota safety net programs," observing that "several of the nearly 100 people under investigation have already pleaded guilty."
"But if federal officials in Minnesota really want to go after industrial-scale fraud, they ought to step up their slow-motion investigation of UnitedHealth Group," Goozner wrote. "The nation’s tattered social safety net, under assault by the Trump administration and shrinking daily, remains prone to abuse by unscrupulous operators. Medicare and Medicaid are especially juicy targets. Most of the perpetrators are lodged within large corporations run by white executives with excellent and expensive legal representation."
"A real crackdown on fraud," he added, "would go after those big fish first."
US President Donald Trump has used unsubstantiated allegations of large-scale fraud in Minnesota's Somali community as a pretext to surge federal agents into the state—with deadly consequences—and cut off federal childcare funding.
But unlike the Somali community, which Trump has subjected to grotesque attacks that have left many fearing for their safety, Minnesota-based UnitedHealth Group (UHG) has not faced the president's public ire.
One of the nation's largest for-profit health insurance companies, UHG is the leading beneficiary of a long-running Medicare Advantage fraud scheme that could cost US taxpayers $1.2 trillion over the next decade—a sum that dwarfs even the White House's wildest claims about the costs of fraud allegedly committed by Somali-run daycares.
The $1.2 trillion estimate comes from a report published earlier this month by the Medicare Payment Advisory Commission (MedPAC), which found that federal overpayments to privately run, publicly funded Medicare Advantage plans will total around $76 billion this year in part due to a practice known as upcoding, whereby insurers present patients as sicker than they actually are to reap larger payments.
UnitedHealthcare, UHG's insurance division, is the leading Medicare Advantage provider in the United States. Stephen Hemsley, UnitedHealth Group's CEO, received a base salary of $1 million last year and a one-time equity award worth $60 million.
ICE/CBP swarms into Minnesota to crack down on government fraud. Somehow they sidestep the orders-of-magnitude higher government fraud by Minnesota-based UnitedHealth, who leads a Medicare Advantage fraud that government analyst MedPac estimates as costing America $76 billion/yr pic.twitter.com/dECnwgUCRV
— David Dayen (@ddayen) January 27, 2026
A Senate report released on January 12 found that UnitedHealth Group uses "aggressive strategies" to maximize patients' so-called "risk-adjustment scores" in an effort to receive larger Medicare Advantage payments from the federal government.
"UHG has turned risk adjustment into a major profit-centered strategy, which was not the original intent of the program," states the report, which was based on more than 50,000 pages of company documents obtained by the Senate Judiciary Committee.
The Senate report cited a 2024 Wall Street Journal investigation showing that "insurer-driven diagnoses by UnitedHealth for diseases that no doctor treated generated $8.7 billion in 2021 payments to the company... UnitedHealth’s net income that year was about $17 billion."
"A real crackdown on fraud would go after those big fish first."
While the US Justice Department—headed by former corporate lobbyist Pam Bondi—is currently investigating UnitedHealth Group over its Medicare billing practices, the Trump administration has enabled the conglomerate's continued expansion and abuses.
Last August, the DOJ settled a Biden-era legal challenge aimed at preventing UnitedHealth Group from absorbing yet another competitor. According to a tracker run by the American Economic Liberties Project, the corporation is still denying necessary care to patients, overbilling the federal government, and engaging in anticompetitive behavior on the Trump administration's watch.
Journalist Merrill Goozner wrote last week that "there is no doubt greedy operators ripped off Minnesota safety net programs," observing that "several of the nearly 100 people under investigation have already pleaded guilty."
"But if federal officials in Minnesota really want to go after industrial-scale fraud, they ought to step up their slow-motion investigation of UnitedHealth Group," Goozner wrote. "The nation’s tattered social safety net, under assault by the Trump administration and shrinking daily, remains prone to abuse by unscrupulous operators. Medicare and Medicaid are especially juicy targets. Most of the perpetrators are lodged within large corporations run by white executives with excellent and expensive legal representation."
"A real crackdown on fraud," he added, "would go after those big fish first."