United Healthcare 2014 Annual Report Download - page 17

Corporate Practice of Medicine and Fee-Splitting Laws. Certain of our businesses function as direct medical
service providers and, as such, are subject to additional laws and regulations. Some states have corporate practice
of medicine laws that prohibit specific types of entities from practicing medicine or employing physicians to
practice medicine. Moreover, some states prohibit certain entities from sharing in the fees or revenues of a
professional practice (fee-splitting). These prohibitions may be statutory or regulatory, or may be imposed
through judicial or regulatory interpretation. The laws, regulations and interpretations in certain states have been
subject to limited judicial and regulatory interpretation and are subject to change.
Consumer Protection Laws. Certain of our businesses participate in direct-to-consumer activities and are subject
to emerging regulations applicable to on-line communications and other general consumer protection laws and
regulations.
Banking Regulation
Optum Bank is subject to regulation by federal banking regulators, including the Federal Deposit Insurance
Corporation, which performs annual examinations to ensure that the bank is operating in accordance with federal
safety and soundness requirements, and the Consumer Financial Protection Bureau, which may perform periodic
examinations to ensure that the bank is in compliance with applicable consumer protection statutes, regulations
and agency guidelines. Optum Bank is also subject to supervision and regulation by the Utah State Department of
Financial Institutions, which carries out annual examinations to ensure that the bank is operating in accordance
with state safety and soundness requirements and performs periodic examinations of the bank’s compliance with
applicable state banking statutes, regulations and agency guidelines. In the event of unfavorable examination
results from any of these agencies, the bank could become subject to increased operational expenses and capital
requirements, enhanced governmental oversight and monetary penalties.
International Regulation
Certain of our businesses operate internationally and are subject to regulation in the jurisdictions in which they
are organized or conduct business. These regulatory regimes encompass, among other matters, tax, licensing,
tariffs, intellectual property, investment, capital (including minimum solvency margin and reserve requirements),
management control, labor, anti-fraud, anti-corruption and privacy and data protection regulations (including
requirements for cross-border data transfers) that vary from jurisdiction to jurisdiction. We currently operate
outside of the United States and in the future may acquire or commence additional businesses based outside of
the United States, increasing our exposure to non-U.S. regulatory regimes. For example, our Amil business
subjects us to Brazilian laws and regulations affecting the managed care and to insurance industries and
regulation by Brazilian regulators including the national regulatory agency for private health insurance and plans,
the Agência Nacional de Saúde Suplementar, whose approach to the interpretation, implementation and
enforcement of industry regulations could differ from the approach taken by U.S. regulators. In addition, our
non-U.S. businesses and operations are subject to U.S. laws that regulate the conduct and activities of U.S.-based
businesses operating abroad, such as the Foreign Corrupt Practices Act (FCPA), which prohibits offering,
promising, providing or authorizing others to give anything of value to a foreign government official to obtain or
retain business or otherwise secure a business advantage.
COMPETITION
As a diversified health and well-being services company, we operate in highly competitive markets. Our
competitors include managed health care companies, insurance companies, HMOs, TPAs and business services
outsourcing companies, health care professionals that have formed networks to contract directly with employers
or with CMS, specialty benefit providers, government entities, disease management companies, and various
health information and consulting companies. For our UnitedHealthcare businesses, our competitors include
Aetna Inc., Anthem, Inc., Cigna Corporation, Health Net, Inc., Humana Inc., Kaiser Permanente, numerous for-
profit and not-for-profit organizations operating under licenses from the Blue Cross Blue Shield Association,
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