{"id":95,"date":"2026-06-01T21:07:20","date_gmt":"2026-06-01T21:07:20","guid":{"rendered":"https:\/\/worcestermovingreport.com\/?p=95"},"modified":"2026-06-01T21:07:20","modified_gmt":"2026-06-01T21:07:20","slug":"unitedhealthcare-defrauded-masshealth-of-100m-ag-alleges","status":"publish","type":"post","link":"https:\/\/worcestermovingreport.com\/?p=95","title":{"rendered":"UnitedHealthcare defrauded MassHealth of $100M, AG alleges"},"content":{"rendered":"
\n

ATTORNEY GENERAL ANDREA CAMPBELL<\/mark><\/strong> sued UnitedHealthcare Insurance Company on Friday, accusing the insurer of misclassifying the conditions of elderly members and defrauding MassHealth of at least $100 million.<\/p>\n

Read more Lessons from Boston on Mass. school segregation lawsuit<\/a><\/p>\n

United fired back that Campbell\u2019s lawsuit is \u201cmeritless\u201d and inaccurately captures the purpose of a managed care program.<\/p>\n

The lawsuit revolves around MassHealth members ages 65 and up enrolled in the Senior Care Options plan. It alleges that United \u201cfalsely manipulated\u201d their health evaluations in order to secure bigger payments, Campbell\u2019s office said. Members are assessed from Level 1 to Level 3, with higher levels corresponding to more serious conditions and higher payment rates.<\/p>\n

\u201cThe state\u2019s managed care plans need to act in good faith on behalf of their members and the financial resources of our state\u2019s Medicaid program,\u201d Campbell said in a statement. \u201cOur investigation found that United Healthcare knowingly violated these obligations by manipulating health assessments to increase its profits. This lawsuit sends a clear message that no company is above the law, and my office will hold companies accountable for exploiting vulnerable residents and misusing taxpayer dollars.\u201d<\/p>\n

The lawsuit, filed in Suffolk Superior Court, comes as MassHealth officials look to slash spending at the agency amid looming federal funding cuts. The agency dominates the state budget and is slated to receive roughly $22 billion in fiscal 2027.<\/p>\n

Campbell\u2019s office said United classified some members as Level 2 \u2014 intended for those with behavioral health or substance use disorders \u2014 even though they \u201clacked any corresponding diagnosis or treatment.\u201d<\/p>\n

Read more Political Notebook: A notable absence in the \u2018Nature for Massachusetts\u2019 coalition<\/a><\/p>\n

The AG also accused United of designating \u201cmany members\u201d as Level 3 even though they did not qualify for that scope of services. Campbell\u2019s office contends United became aware of the Level 3 misclassifications through internal reviews but \u201cnever disclosed\u201d the issue to MassHealth or repaid MassHealth \u201cfor any of the improperly inflated payments.\u201d<\/p>\n

United also submitted assessments that said members needed daily skilled nursing services, while \u201cmost\u201d of those individuals did not receive or need that care, the lawsuit alleges.<\/p>\n

In a statement to the News Service, United said it is focused on working \u201cwith our state partner to help our members live healthier lives.\u201d<\/p>\n

\u201cThe Massachusetts Attorney General\u2019s complaint is meritless and doesn\u2019t accurately describe our Senior Care Options program, which helps seniors with complex care meet their individual health needs,\u201d United said. \u201cThe 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.\u201d<\/p>\n

Read more Senate\u2019s new audit compliance raises more questions than it answers<\/a><\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

ATTORNEY GENERAL ANDREA CAMPBELL sued UnitedHealthcare Insurance Company on Friday, accusing the insurer of misclassifying the conditions of elderly<\/p>\n","protected":false},"author":1,"featured_media":94,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3],"tags":[],"class_list":["post-95","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-politics"],"yoast_head":"\nUnitedHealthcare defrauded MassHealth of $100M, AG alleges - Worcester Moving Report<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/worcestermovingreport.com\/?p=95\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"UnitedHealthcare defrauded MassHealth of $100M, AG alleges - Worcester Moving Report\" \/>\n<meta property=\"og:description\" content=\"ATTORNEY GENERAL ANDREA CAMPBELL sued UnitedHealthcare Insurance Company on Friday, accusing the insurer of misclassifying the conditions of elderly\" \/>\n<meta property=\"og:url\" content=\"https:\/\/worcestermovingreport.com\/?p=95\" \/>\n<meta property=\"og:site_name\" content=\"Worcester Moving Report\" \/>\n<meta property=\"article:published_time\" content=\"2026-06-01T21:07:20+00:00\" \/>\n<meta name=\"author\" content=\"admin\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"admin\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"2 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/worcestermovingreport.com\\\/?p=95#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/worcestermovingreport.com\\\/?p=95\"},\"author\":{\"name\":\"admin\",\"@id\":\"https:\\\/\\\/worcestermovingreport.com\\\/#\\\/schema\\\/person\\\/690f2c82d115bde885a331998fa0eae0\"},\"headline\":\"UnitedHealthcare defrauded MassHealth of $100M, AG alleges\",\"datePublished\":\"2026-06-01T21:07:20+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/worcestermovingreport.com\\\/?p=95\"},\"wordCount\":450,\"commentCount\":0,\"image\":{\"@id\":\"https:\\\/\\\/worcestermovingreport.com\\\/?p=95#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/worcestermovingreport.com\\\/wp-content\\\/uploads\\\/2026\\\/06\\\/9e39d20c2a7d0f808434ff8da4616fe0.jpg\",\"articleSection\":[\"Politics\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/worcestermovingreport.com\\\/?p=95#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/worcestermovingreport.com\\\/?p=95\",\"url\":\"https:\\\/\\\/worcestermovingreport.com\\\/?p=95\",\"name\":\"UnitedHealthcare defrauded MassHealth of $100M, AG alleges - 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