UnitedHealthcare CEO murder suspect Luigi Mangione faces New York extradition after ending fight

Luigi Mangione, the suspect accused of murdering UnitedHealthcare CEO Brian Thompson on Dec. 4 in Manhattan, is headed back to New York City after waiving extradition on Thursday morning.

Mangione, 26, faces murder charges in New York, where officials are working to extradite him as soon as possible from Pennsylvania, where he is currently incarcerated on other charges. 

Mangione arrived at the Blair County Courthouse in Hollidaysburg around 7:40 a.m. Thursday and was escorted by police. He did not say anything as he entered the building. 

A New York Police Department officer also walked in through that back entrance, and NYPD officers were seen sitting in the entire front row of the room where Mangione's court proceedings took place.

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Several people outside the courthouse held signs that read "Deny, Defend, Depose," the same message that Mangione allegedly left on shell casings at the scene of Thompson's murder and words that are commonly used among insurance providers when they reject claims. 

The court covered his extradition hearing, as well as a preliminary hearing for his other firearms and fraudulent ID-related charges in Pennsylvania. The first hearing regarding his state charges ended around 9:20 a.m., at which point his Altoona-based attorney, Thomas Dickey, left the courtroom before reentering about 20 minutes later. He spoke to Mangione, who nodded his head, ahead of the extradition hearing portion of Thursday's proceedings.

Mangione may also be facing federal charges in the near future, according to The New York Post.

"The federal government's reported decision to pile on top of an already overcharged first-degree murder and state terror case is highly unusual and raises serious constitutional and statutory double jeopardy concerns," his New York defense attorney, Karen Friedman Agnifilo, told Fox News Digital. "We are ready to fight these charges in whatever court they are brought."

New York prosecutors say Mangione plotted to travel to New York; find Thompson, a Minnesota resident in town for UnitedHealthcare's annual shareholder conference; and kill him. Mangione allegedly shot Thompson from behind with a 3D-printed ghost gun and suppressor. 

Manhattan District Attorney Alvin Bragg on Tuesday announced that a grand jury indicted Mangione on one count of first-degree murder, in furtherance of terrorism; two counts of second-degree murder; two counts of second-degree criminal weapons possession; four counts of third-degree criminal weapons possession; one count of fourth-degree criminal weapons possession; and one count of second-degree criminal possession of a forged instrument.

Prosecutors say Mangione fled New York City within an hour after the crime and traveled to Altoona, Pennsylvania.

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Altoona police arrested Mangione in a McDonald's five days later on Dec. 9 after receiving a tip from an employee. The suspect allegedly presented local police with a fake ID and appeared to start shaking when they asked if he had been in New York recently.

Police said the suspect took a bus from New York City to Philadelphia, and then from Philadelphia to Pittsburgh and on to Altoona — a rust-belt town nestled between Pittsburgh and Harrisburg.

Officials also found a handwritten manifesto condemning the health care industry, as NYPD Chief of Detectives Joseph Kenny previously told Fox News. The manifesto specifically mentioned UnitedHealthcare.

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While officials have not commented on an official motive, the public has speculated that the suspect had strong grievances with both the health care insurance industry.

The 26-year-old suspect is originally from Maryland and has recently lived in California and Hawaii. Mangione graduated valedictorian from the Gilman School, a private, all-boys high school in Baltimore, in 2016. He went on to receive his bachelor's and master's degrees in computer science from the University of Pennsylvania in 2020.

The day after his arrest in Altoona, on Dec. 10, Mangione announced that he would not waive extradition.

"We did not waive extradition and we're contesting extradition. We are going to fight this along the rules and with the constitutional protections that my client has," Magione's attorney, Thomas Dickey, told reporters outside the Blair County Courthouse on Dec. 10.

Sources told Fox News on Tuesday, though, that Mangione plans to give up that fight and waive extradition, clearing the way for his return to New York City. If he does waive extradition, he will immediately be transported into NYPD custody.

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New York officials, meanwhile, say they are doing everything they can to get Mangione back to Manhattan.

"Now that [DA Bragg] has filed an indictment for the murder of Brian Thompson, New York stands ready to do whatever it takes to hold the killer accountable," New York Gov. Kathy Hochul wrote on X Wednesday. "We’ve heard reports that the defendant will waive his extradition rights. If not, I am prepared to request a governor’s warrant as soon as possible to ensure he is held and tried in New York." 

Fox News' David Hammelburg, Alexis McAdams, Maria Parnovich and David Hammelburg contributed to this report.