BOSTON (SHNS) – Attorney General Andrea Campbell sued UnitedHealthcare Insurance Company on Friday, accusing the insurer of misclassifying the conditions of elderly members and defrauding MassHealth of at least $100 million.
United fired back that Campbell’s lawsuit is “meritless” and inaccurately captures the purpose of a managed care program.
The lawsuit revolves around MassHealth members ages 65 and up enrolled in the Senior Care Options plan. It alleges that United “falsely manipulated” their health evaluations in order to secure bigger payments, Campbell’s office said. Members are assessed from Level 1 to Level 3, with higher levels corresponding to more serious conditions and higher payment rates.
Lawsuit against UnitedHealthcare Insurance CompanyDownload
“The state’s managed care plans need to act in good faith on behalf of their members and the financial resources of our state’s Medicaid program,” Campbell said in a statement. “Our 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.”…