Exposed: Optum (UnitedHealth Group)

Optum is the healthcare technology and services arm of UnitedHealth Group, the largest health insurance conglomerate in the United States. In February 2024, Optum subsidiary Change Healthcare suffered the most catastrophic healthcare data breach in American history, exposing the protected health information of over 100 million individuals including Social Security numbers, medical diagnoses, treatment records, insurance claims, and billing data. The breach was caused by a ransomware attack on systems that lacked basic multi-factor authentication, and UnitedHealth Group reportedly paid a $22 million ransom to the attackers. Beyond the breach, Optum has been accused of deploying AI algorithms to systematically deny patient claims at scale, with internal documents showing that the company used predictive models to automatically reject Medicare Advantage claims with a denial rate exceeding 90% for certain categories of post-acute care. A class-action lawsuit filed in November 2023 alleged the AI system, called nH Predict, was overriding physician recommendations to cut costs. Optum processes claims for approximately 130 million Americans and controls the largest pharmacy benefit manager, OptumRx, giving it unprecedented control over both the insurance approval and medication dispensing pipeline. The company also operates Optum Health, a network of 90,000 physicians, creating a vertically integrated healthcare surveillance system that tracks patients from diagnosis through treatment and payment.