• Prosecutors in New York charged Ivy League grad Luigi Mangione with the murder of UnitedHealthcare CEO Brian Thompson, court records show.
• The charge came hours after Mangione was arraigned in a Pennsylvania courtroom on gun and other charges related to his arrest earlier Monday at a McDonald's in Altoona, Pennsylvania.
• Mangione is accused of gunning down Thompson as the CEO headed into an investor meeting for UnitedHealth Group, the parent of his health insurance giant.

New York prosecutors on Monday charged Ivy League grad Luigi Mangione with the murder of UnitedHealthcare CEO Brian Thompson, court records show.

The charge came hours after Mangione, 26, was arraigned in a Pennsylvania courtroom on gun and other charges related to his arrest earlier Monday at a McDonald's in Altoona, Pennsylvania, after a worker there told police he was acting suspiciously.

Mangione was charged by the Manhattan district attorney's office with second-degree murder, criminal possession of a loaded firearm, possession of a silencer and possession of a forged instrument in state court in Manhattan on Monday night, according to a court record.

He is accused of fatally shooting Thompson early Wednesday morning outside the Hilton hotel in midtown Manhattan.

Thompson, a 50-year-old father of two, was headed to an investor meeting for UnitedHealth Group, which owns his company when he was shot by a masked gunman with a pistol that appeared to have a silencer attached.

New York Police Commissioner Jessica Tisch has said the shooter lay in wait for several minutes for Thompson before executing what she called a "premeditated, preplanned targeted attack."

Shell casings found at the scene had the words "delay," "deny" and "depose" written on them. The first two of those words are sometimes used to describe the tactics of health insurers, such as Thompson's, to limit the amount of benefits paid out to customers.

UnitedHealthcare is the largest private health insurer in the United States, with more than $200 billion in annual revenue.

The U.S. Senate Permanent Subcommittee on Investigations in October released a report that found UnitedHealthcare, Humana and CVS "each denied prior authorization requests for post-acute care at far higher rates than they did for other types of care, resulting in diminished access to post-acute care for Medicare Advantage beneficiaries." Medicare Advantage offers health benefits under the federal Medicare program that are managed by private insurance companies.

Mangione, whose sister is a doctor, reportedly has suffered from chronic back pain for years. The profile of his account on the social media account X contains an x-ray image of a person's back with screws in it.

Thompson's family held a private funeral for him in Minnesota earlier Monday, as Mangione was being taken into custody and questioned by Altoona police.

Police said that a backpack with Mangione when he was confronted at the McDonald's was found to contain a gun, silencer and multiple rounds of 9 mm ammunition.

Altoona police said that when Mangione removed his face mask at the McDonald's at their request they immediately recognized him as the person sought by New York authorities in connection with Thompson's killing.

He was taken into custody after giving officers a fake New Jersey ID that is believed to be the same one he used to check into a Manhattan hostel in late November.

Mangione, who comes from a wealthy Baltimore-area family, is being held without bond at a jail in Pennsylvania on the charges in that state relating to the gun and phony IDs he was carrying.

The suspect, who graduated in 2020 with both bachelor's and master's degrees from the University of Pennsylvania, at the time of his arrest was carrying a handwritten manifesto that referenced the health-care industry.

In a statement released after his arrest in Pennsylvania, Mangione's family said, "Our family is shocked and devastated by Luigi's arrest."

"We offer our prayers to the family of Brian Thompson and we ask people to pray for all involved," the statement said. "We are devastated by this news."

Before his arrest Monday, police in New York did not know Mangione's identity even as they sought a "person of interest" who was seen on surveillance images traveling to and from the scene of Thompson's slaying.

Those images were widely publicized and had been seen by the officers who apprehended Mangione in Altoona.

Most of the images showed a person wearing a mask or gaiter over their face. But two images showed the man believed to be Mangione when he was at the hostel, and a female worker there asked him to show her his face.

Authorities believe the gunman fled New York within hours of that shooting, possibly on a bus from the Port Authority terminal in Washington Heights, in northern Manhattan.