May 29 (Reuters) – Massachusetts sued a UnitedHealth insurance unit on Friday, accusing it of defrauding the state’s Medicaid program out of more than $100 million by making older patients appear more seriously ill than they actually were.
Andrea Joy Campbell, the Massachusetts attorney general, said UnitedHealthcare Insurance, which operates as UnitedHealthcare Community Plans of Massachusetts, falsely manipulated the health status of MassHealth members enrolled in its Senior Care Options plan to secure higher payments.
UnitedHealth, in a statement, called the complaint “meritless.”
Campbell accused UnitedHealth of submitting inaccurate diagnoses for patients 65 and older between 2015 and 2025, to receive higher payments from MassHealth and advance the company’s “growth-at-all-costs strategy.”
The lawsuit accuses UnitedHealth of submitting false claims and unjust enrichment. It seeks to recoup money that MassHealth improperly paid, and seeks triple damages.
(Reporting by Jonathan Stempel in New York: Editing by Chiara Rodriquez)
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