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The Problem Room Antitrust & Federal Scrutiny

The Thread · Federal & State Enforcement

Antitrust & Federal Scrutiny

When one company owns the insurer, the doctors, the pharmacy, and the data, regulators eventually notice. Here is the enforcement record on UnitedHealth's consolidation.

The Documented Record

FTC · PBMs

FTC sues the "Big Three" PBMs, including OptumRx

For rebating practices that allegedly inflate insulin list prices and block cheaper generics.

FTC · Middleman

FTC accuses CVS, Cigna & UnitedHealth of abusing their middleman role

Across the vertically integrated PBM-insurer model.

DOJ · Antitrust

DOJ investigates Optum's acquisition of doctor's offices

A civil antitrust review of UHG's growing control over physician groups.

DOJ · Merger Conditioned

DOJ sues to block UHG's acquisition of Amedisys

Settled with divestitures across multiple states and a $1.1M civil penalty for false certification.

DOJ · Abandoned

UHG abandons the Stewardship Health acquisition

After intense DOJ Antitrust Division scrutiny over care quality and competition.

State AG

AG James acts to protect health-service access in Western NY

Multistate attention to UnitedHealth's market conduct.

Congress

"Too big to fail?" — lawmakers eye a breakup of UnitedHealth

Bipartisan momentum toward structural separation (see S.3822).

Senate

Senate report & Grassley inquiry on Medicare Advantage

A scathing report on MA denials, plus Sen. Grassley's letters and report on UHG's billing.

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