Hunterbrook Media released a report on January 8 2026 alleging that UnitedHealth Group, CVS Health, and Cigna are using shell Group Purchasing Organization entities—Emisar for UnitedHealth, Zinc for CVS, and Ascent for Cigna—to collect fees from drug manufacturers while publicly claiming that 100 % of rebates are passed to customers. The report argues that the fees siphoned from the rebate stream could amount to billions of dollars.
UnitedHealth’s Optum PBM arm has long pledged to pass all rebates to payers. CEO Andrew Witty announced in January 2025 that Optum Rx would achieve 100 % pass‑through by 2028, and the company currently passes through 98 % of rebates. The Hunterbrook allegations suggest that the remaining 2 % is retained through the shell GPOs, contradicting the company’s public commitment and potentially violating federal regulations that require transparent rebate distribution.
The report identifies Emisar as a shell entity with minimal staff that generates substantial revenue from drug manufacturers. Similar structures exist for CVS (Zinc) and Cigna (Ascent). The allegations are set against a backdrop of ongoing regulatory scrutiny, including an FTC lawsuit filed in September 2024 that accuses Optum Rx, Caremark, and Express Scripts of inflating insulin prices through a “perverse drug rebate system.” The FTC’s case underscores the industry’s vulnerability to anti‑competitive practices.
UnitedHealth’s financial performance provides context for the potential impact of the allegations. In Q4 2024, the company reported $5.8 billion in net income on $101 billion in revenue, compared with $5.7 billion on $94 billion in Q4 2023. Optum Rx generated $130 billion in revenue in 2024, a 15 % increase from the prior year, and is projected to reach $146 billion in 2025. The allegations, if proven, could erode investor confidence and trigger regulatory investigations that might result in fines or operational restrictions.
Market reaction to the Hunterbrook report has been muted, with no immediate regulatory filings or public statements from UnitedHealth. The company has yet to issue a rebuttal, and analysts are monitoring the situation closely. The lack of a formal response suggests that UnitedHealth is still assessing the claims and determining the appropriate communication strategy.
Management has emphasized the importance of transparency and has reiterated its commitment to increasing rebate pass‑through. Witty stated that the remaining 2 % of rebates is retained only because some clients prefer that arrangement, but the company is phasing it out to eliminate any “excuse” for criticism. The allegations raise questions about the alignment between UnitedHealth’s stated policies and its actual rebate practices, potentially affecting the company’s reputation and its ability to attract and retain payers.
The broader PBM industry is under bipartisan legislative pressure to reform rebate practices and increase transparency. Bills introduced in Congress aim to regulate rebate structures and curb anti‑competitive behavior. Hunterbrook’s findings, if substantiated, could accelerate regulatory action and prompt other PBMs to reassess their own rebate arrangements.
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