From Franklin, Tenn.-based Community Health Systems to Norfolk, Va.-based Sentara Health, the Justice Department has been busy looking into multiple health systems and healthcare organizations over the last few months.
Most recently, Los Angeles-based Prospect Medical Holdings shared in June 27 court documents that the Justice Department had issued Prospect a civil investigation demand on Nov. 3.
The court documents were filed in relation to a lawsuit that Yale New Haven (Conn.) Health filed against Prospect in May regarding the sale of three Prospect hospitals. The documents did not go into detail about the Justice Department's investigation.
A civil investigation allows the department to access documented and electronically stored information from a person or entity before litigation begins, according to Bloomberg Law.
In April, it was revealed that the Justice Department has been investigating Sentara Health's insurance arm, Optima Health, now known as Sentara Health Plans, since 2021.
The investigation pertains to whether Optima unfairly increased premiums in 2018 and 2018 after receiving more than $655 million in federal subsidies.
The Justice Department alleged that while Sentara complied with certain requests for testimony and documents, it refused to comply with others. Optima President and CEO Michael Dudley and Optima Chief Actuary James Juillerat were ordered by a federal judge in March to provide additional testimony within 60 days.
A Sentara spokesperson told The Virginia-Pilot that the health system has worked with investigators to provide over 27,000 documents and 60 hours of interviews with existing and former employees.
UnitedHealth Group was also hit with an antitrust investigation in February from the Justice Department.
Around that time, The Wall Street Journal reported that investigators had begun conducting interviews with healthcare industry representatives in UnitedHealth competition sectors, which included physician groups.
During the interviews, questions were related to specific relationships between the company's UnitedHealthcare insurance unit and its Optum health-services arm, which owns additional assets like physician groups.
The inquiry, in part, was looking into acquisitions from Optum's physician group and how the health plan unit and physician ownership impact competition. Specifically, investigators from the Justice Department asked if UnitedHealthcare favored Optum-owned groups in contract pricing, which could extract rival physicians from certain appealing payment arrangements.
Lastly, Community Health Systems revealed in a Feb. 21 SEC filing that on January 11, the health system received a civil investigative demand from the Justice Department looking for information and documents related to, "a variety of subjects, including practices and procedures related to the utilization review, inpatient admission and inpatient dialysis at our hospitals."
The health system also shared in the statement that it was fully cooperating with the investigation.
A spokesperson from CHS told Becker's that the health system believes the investigation came from allegations of a former employee at one of its hospitals.