Justice Department Orders UnitedHealth to Sell Assets to Resolve Amedisys Acquisition Challenge

UnitedHealth to Divest $528M in Assets to Settle DOJ Antitrust Challenge

WASHINGTON, D.C. – The Justice Department has reached a proposed settlement with UnitedHealth Group Incorporated regarding its $3.3 billion acquisition of Amedisys Inc., requiring the company to divest 164 home health and hospice locations across 19 states. The deal, announced today, aims to protect competition in the healthcare sector and prevent potential harm to patients and healthcare workers.

In addition to the divestitures,representing approximately $528 million in annual revenue,Amedisys will pay a $1.1 million civil penalty for providing false certifications during the hart-Scott-Rodino (HSR) Antitrust Improvements Act review process.

“In no sector of our economy is competition more importent to Americans’ well-being than healthcare,” said Assistant Attorney General Abigail Slater of the Justice Department’s Antitrust Division. “This settlement protects quality and price competition for hundreds of thousands of vulnerable patients and wage competition for thousands of nurses.”

The proposed settlement secures the largest divestiture of outpatient healthcare services in a merger challenge to date. Key components of the agreement include:

Extensive Divestitures: UnitedHealth and Amedisys must sell off 164 home health and hospice locations, including one palliative care facility, across 19 states.
Contingency Divestitures: An additional eight locations must be divested if regulatory approval isn’t secured for associated facilities.
Self-reliant Monitoring: A monitor will oversee the asset divestitures and ensure compliance with the consent decree.
Competitive Support for Buyers: Divestiture buyers will receive the necessary assets,personnel,and relationships to effectively compete with UnitedHealth.
* Antitrust Compliance: Amedisys will implement enhanced antitrust compliance training for its leadership and pay a $1.1 million penalty for past misrepresentations.

The Justice Department’s action follows unitedhealth’s 2023 acquisition of LHC Group Inc., another meaningful player in the home health and hospice market.

The proposed settlement will be published in the Federal Register, initiating a 60-day public comment period. Interested parties can submit comments to Jill Maguire, Acting Chief, Healthcare and Consumer Products Section, Antitrust Division, U.S. Department of Justice, 450 Fifth Street NW, Suite 4100, Washington, DC 20530. The U.S. District Court for the District of Maryland will ultimately decide weather to approve the final judgment based on its assessment of the public interest.UnitedHealth is a diversified healthcare company offering insurance, provider services, pharmacy benefits management, and healthcare software. Amedisys provides home health and hospice services.

How might the DOJ’s intervention impact the affordability of home healthcare services for Medicare and Medicaid beneficiaries?

The DOJ’s Intervention in the Home Health Landscape

on August 7, 2025, the Department of Justice (DOJ) announced a settlement with UnitedHealth Group regarding its proposed acquisition of Amedisys, a leading provider of home health and hospice services. The core of the agreement requires UnitedHealth to divest certain Amedisys assets to address antitrust concerns. This decision significantly impacts the healthcare industry, specifically the growing home healthcare market. The DOJ’s action underscores increasing scrutiny of consolidation within the sector.

Understanding the Amedisys Acquisition and DOJ Concerns

UnitedHealth’s planned $3.3 billion acquisition of Amedisys,announced in September 2023,aimed to expand UnitedHealth’s presence in the rapidly expanding home healthcare space. However, the DOJ argued that the acquisition, as originally proposed, would have substantially lessened competition in several local markets for home health services.

Specifically, the DOJ focused on:

Concentrated Markets: Several geographic areas where both UnitedHealth and Amedisys have important market share.

Reduced Choice: The potential for fewer options for patients requiring home health and hospice care.

Price Increases: Concerns that reduced competition could lead to higher costs for Medicare, Medicaid, and private insurers.

Innovation Stifled: The possibility that less competition would diminish incentives for innovation in service delivery.

The DOJ’s lawsuit, filed in February 2024, sought to block the acquisition entirely. This settlement represents a compromise, allowing the deal to proceed with conditions.

The divestiture Plan: What Assets Must UnitedHealth Sell?

To resolve the antitrust challenge, UnitedHealth has agreed to divest Amedisys’ home health and hospice agencies in the following states:

Alabama

Indiana

Louisiana

Mississippi

North Carolina

South Carolina

These divestitures represent a considerable portion of Amedisys’ operations and are designed to restore competition in the affected markets. The DOJ requires UnitedHealth to find a buyer approved by the agency, ensuring the divested assets remain a viable competitive force. The buyer must be a company with experience in home health services and a commitment to maintaining quality care.

Impact on the Home Healthcare Industry

This decision sends a clear signal to other players in the healthcare mergers and acquisitions space. The DOJ is actively monitoring consolidation trends and will intervene when it believes competition is threatened.

Here’s how this impacts the industry:

Increased Scrutiny: Future acquisitions in the home health sector will likely face heightened regulatory review.

Opportunities for Competitors: The divestiture creates opportunities for other home health providers to expand their footprint. Potential buyers are already being evaluated.

Focus on Value-based Care: The emphasis on competition could drive innovation and a greater focus on value-based care models.

Market Dynamics Shift: The competitive landscape in the divested states will be reshaped, potentially benefiting patients through increased choice and potentially lower costs.

Implications for Patients and Caregivers

The DOJ’s intervention ultimately aims to protect patients and caregivers. Maintaining a competitive market for home health services is crucial for:

Access to Care: ensuring patients have access to a range of providers.

Quality of Care: Encouraging providers to maintain high standards of care to attract patients.

Affordability: Preventing price gouging and ensuring affordable access to essential services.

Patient choice: Empowering patients to choose the provider that best meets their needs.

The Role of Medicare and Medicaid

The DOJ’s concerns were particularly focused on the impact on Medicare and Medicaid beneficiaries, who rely heavily on home health services. these programs are significant purchasers of home healthcare, and reduced competition could lead to increased costs for taxpayers. The settlement aims to safeguard these vital programs. Medicare Advantage plans, often affiliated with UnitedHealth, will also be affected by these changes.

Looking Ahead: future of Home Health Regulation

The UnitedHealth-Amedisys case is a landmark decision that will likely shape the future of home health regulation. The DOJ’s willingness to challenge a major acquisition demonstrates its commitment to preserving competition in this critical sector. Expect continued scrutiny of healthcare consolidation and a focus on protecting patient access to affordable, high-quality care. The evolving regulatory landscape requires healthcare providers to stay informed and adapt their strategies accordingly.