Massachusetts sues UnitedHealthcare over alleged Medicaid fraud
Massachusetts Attorney General Andrea Campbell filed a lawsuit against UnitedHealthcare alleging the company manipulated health status records of Medicaid members to obtain higher payments of at least $100 million.
The lawsuit claims UnitedHealthcare incentivized field nurses to code MassHealth members enrolled in the Senior Care Options plan as sicker or less capable than their actual conditions warranted, according to the complaint.
UnitedHealthcare spokesperson Eric Hausman disputed the allegations in an emailed statement, calling the complaint "meritless" and stating it does not accurately describe the company's Senior Care Options program.
"The Attorney General is simply wrong that Massachusetts seniors with complex care needs should not be receiving the support and services UnitedHealthcare is helping to provide," Hausman said.
The Senior Care Options plan serves Medicaid members through the state's MassHealth program. The lawsuit represents the latest legal action by state authorities against major health insurers over billing practices in government-funded healthcare programs.
