WITH DEPARTMENT OF JUSTICE INVESTIGATION INTO UNITEDHEALTH DELAYED BY STAFF REDUCTIONS, CONGRESSMAN PAT RYAN DEMANDS AG BONDI TAKE IMMEDIATE ACTION TO PROTECT AMERICANS FROM HEALTHCARE MONOPOLIES
With Department of Justice Investigation Into UnitedHealth Delayed By Staff Reductions, Congressman Pat Ryan Demands AG Bondi Take Immediate Action to Protect Americans from Healthcare Monopolies
Optum Health, a subsidiary of UnitedHealth Group, has purchased medical practices across the Hudson Valley, with market control of more than 2,500 providers at CareMount Medical and Crystal Run Healthcare and 1 in 10 doctors nationwide
Congressman Ryan’s community inquiry on UnitedHealth garnered thousands of responses detailing the avalanche of dysfunction at the practices; results were submitted to the Department of Justice, Department of Health and Human Services, and Federal Trade Commission for further investigation
UnitedHealth is facing multiple investigations by the Department of Justice, including an antitrust review of Optum’s acquisition of doctor’s offices; recently it was announced that the investigation was delayed due to staffing shortages following Trump’s cuts at the DOJ
WASHINGTON, DC – Today, Congressman Pat Ryan turned up pressure on Attorney General Pam Bondi to preserve and strengthen the Justice Department’s investigation into UnitedHealth Group and Optum, following reports that staff reductions are delaying a monopolization suit against the company.
Optum Health, a subsidiary of UnitedHealth Group, has purchased medical practices across the Hudson Valley, with market control of more than 2,500 providers at CareMount Medical and Crystal Run Healthcare and 10 percent of doctors nationwide. Congressman Ryan’s community inquiry on UnitedHealth garnered thousands of responses detailing the avalanche of dysfunction at Optum-owned practices, most commonly citing declining quality of care, an increase in fees and incorrect billing, and issues with customer service and accessibility negatively impacting people’s ability to get health care. Congressman Ryan submitted the results to the Department of Justice, Department of Health and Human Services, and Federal Trade Commission for further investigation; UnitedHealth is facing multiple investigations by the Department of Justice, including an antitrust review of Optum’s acquisition of doctor’s offices which – according to recent reporting – has been delayed due to staffing shortages following Trump’s cuts at the DOJ.
“Through my community inquiry into United, I heard from parents of disabled children unable to get treatment, mothers waiting almost a year for a cancer diagnosis, and families slammed by thousands of dollars of overcharges. All so the largest health care company in the world can continue to make record-breaking profits. Now the Justice Department is delaying its monopoly investigation – and it’s American families who pay the price,” said Congressman Pat Ryan. “United owns the insurance company, they own your doctor, they own the pharmacy and they own the software that processes all of your information – and they use it all to keep prices high and drive quality down. Enough. I’m urging the Justice Department and Pam Bondi to do their jobs and make sure this investigation continues without delay, so that we can hold UnitedHealth accountable and ensure that Americans across the country are able to get the care they deserve at a price they can afford.”
Across the country, UnitedHealth’s Optum has purchased doctor’s offices at an aggressive pace. It has become the largest employer of doctors, with one in ten physicians nationwide now under its control. UnitedHealth Group also owns the largest insurance company, one of the three largest Pharmacy Benefit Managers, and the largest medical claims manager. UnitedHealth has used this vast power to rip off patients and enrich its shareholders, with profits of $14 billion in 2024.
In 2022, Optum purchased CareMount Medical, a medical group with over 2,100 providers and 1.6 million patients in the tri-state area. In 2023, Optum further consolidated the market for physician services in the Hudson Valley with its acquisition of Crystal Run Healthcare, with about 400 providers. Patients have reported that the shift to Optum has worsened the quality of their care and reduced access to medical providers. This includes difficulty scheduling doctor’s appointments, inaccurate billing, unexplained fees, long wait times, and poor customer service. In addition, Optum employees have reported layoffs and chaotic, overburdened work schedules, leading to staff burnout.
In the Hudson Valley, concerning reports have emerged that UnitedHealth may be paying its own Optum practices more in order to squeeze local competitors, as well as manipulating patients’ medical records in order to receive higher payments under the Medicare program. United is facing multiple investigations by the Department of Justice, including an antitrust review of Optum’s acquisition of doctor’s offices that was opened in February 2024. According to reports, investigators are looking into anticompetitive harms for patients and providers.
Throughout his time in office, Congressman Ryan has always emphasized the importance of lowering costs, specifically when it comes to health care. He supports landmark legislation which has already lowered the prices of ten of the most common high-cost pharmaceuticals, fought to lower premiums for 20 million Americans receiving healthcare through the Affordable Care Act, and secured more than $2 million to expand services at Sun River Health in Beacon.
Congressman Ryan is a cosponsor of the Drug Price Transparency in Medicaid Act, which would prohibit PBMs from charging Medicaid more than they paid pharmacies for a drug. He also co-leads the Pharmacists Fight Back Act, comprehensive legislation to require adequate reimbursements to pharmacists, prohibit PBMs from steering patients to their own pharmacies, and eliminate PBM restrictions on patient choice. Large portions of these bills were set to be included in the December government funding legislation until they were removed at the last minute.
Congressman Ryan also recently reintroduced the Stopping Pharma’s Ripoffs and Drug Savings for All Act, as a part of his broader Affordability Agenda; the Congressman’s first legislation of the 119th Congress which aims to lower costs across the board. The Stopping Pharma’s Ripoffs Act would rein in Big Pharma’s current abuse of U.S. patent law, and make it easier to produce less-costly generic drug alternatives.
The full text of Congressman Ryan’s letter to AG Bondi and Assistant AG Slater can be found below:
Dear Attorney General Bondi and Assistant Attorney General Slater:
I write to express my deep concern regarding delays to the Antitrust Division’s investigation into UnitedHealth Group’s ownership of doctor’s offices.
As you know, last year the Antitrust Division of the Department of Justice opened an investigation into UnitedHealth’s troubling and rapidly growing control over physician groups through its subsidiary, Optum Health. However, recent reporting indicates that staff reductions at the DOJ are threatening the timeline of this investigation, potentially delaying a monopolization suit until late 2025. This is unacceptable – you must swiftly and vigorously pursue this investigation to protect my constituents from the worst effects of corporate consolidation in healthcare. I urge you to take immediate action to ensure the Antitrust Division’s investigation into UnitedHealth and Optum proceeds in a timely manner, and to take strong enforcement action as necessary.
UnitedHealth Group has become the largest healthcare company in the United States through a strategy of aggressive consolidation, expanding from its original insurance business into pharmacy benefit management, claims processing, and physician services. Today, UnitedHealth has a major stake in nearly every sector of the healthcare system. Optum, United’s physician services division, is now the largest employer of physicians in the United States, with over 90,000 employed or affiliated doctors – approximately 10% of all physicians in the US. This represents an astonishing increase of over 20,000 physicians since 2022.
In the Hudson Valley of New York, Optum has continued buying up physician offices at a rampant pace. In 2022, Optum purchased CareMount Medical, a multi-specialty medical group with over 2,100 providers and 1.6 million patients. In 2023, Optum further consolidated the market for physician services in the Hudson Valley with its acquisition of Crystal Run Healthcare, a physician group with about 400 providers.
These acquisitions have reshaped health care in our community. Whereas my constituents were once served by local independent physician groups, their care is now increasingly in the hands of just one massive corporate conglomerate. I’ve heard directly from constituents – including thousands who have responded to a community inquiry I launched – that the shift to Optum has worsened the quality of their care and reduced access to medical providers in the area. Patients frequently cite problems that include reduced availability of doctors, shorter appointments, longer wait times on the phone, and more frequent scheduling mishaps and delays, with some patients waiting up to a year for medically critical appointments.
These issues stem from deliberate decisions by Optum to cut costs, reduce quality, and maximize profit. For example, Optum changed CareMount’s existing procedures regarding same-day appointments for sick patients. According to a doctor employed by the company, “We used to be able to reserve several office visit openings a day for those that call in the morning who need a sick visit…Optum did away with this availability to be sure every single time slot possible was booked up several days in advance, thus ensuring maximum patient visits for max profits.” In addition, patients and doctors have raised serious concerns that Optum’s billing practices are unfair and exploitative, with one-quarter of Optum patients who responded to my survey reporting double billing, inaccurate bills, and confusing or unexplained charges.
I am also deeply concerned by the conflicts of interest inherent in Optum’s ownership by UnitedHealth Group, which also owns the largest health insurance company in the US. Multiple credible reports indicate that Optum pressures its doctors into manipulating billing codes attached to patients’ medical records in order to boost payments from the federal government to United’s Medicare Advantage plans. This practice – known as “upcoding” – puts United’s profits ahead of accurate diagnoses, making patients seem sicker than they actually are and leaving consumers and taxpayers on the hook for significantly higher costs.
United’s ownership of Optum also creates a strong incentive for United’s insurance arm to pay its own Optum practices significantly more than competitors – squeezing independent doctors out of business and leading to even further consolidation in local markets. Indeed, one analysis finds that UnitedHealthcare pays its own Optum practices in the Hudson Valley between 41-91% more than the average market rate. The result is that local providers unaffiliated with the corporate giant are unable to compete, forcing them to close up shop or sell out to larger systems.
United’s growing consolidation over the market for outpatient medical care does serious anticompetitive harm to patients and rival physicians alike. Yet UnitedHealth Group and Optum continue to line their pockets, with profits growing to $14.4 billion last year. Given the conglomerate’s large and growing place in our healthcare system, the Department of Justice has a responsibility to protect patients and guarantee fair competition. To that end, I urge you to prioritize your investigation into UnitedHealth Group’s ownership of Optum and to take strong enforcement action without delay.
Thank you for your attention to this request. I commend your ongoing work to enforce antitrust law, and stand ready to work with you on this critical investigation.
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