STAT+: Massachusetts sues UnitedHealth, alleging fraud in state’s Medicaid plans for seniors

STAT PlusExclusive Massachusetts sues UnitedHealth, alleging fraud in state’s Medicaid plans for seniors UnitedHealth made low-income seniors seem sicker than they were, attorney general alleges Manage alerts for this article Email this article Share this article By Bob HermanMay 29, 2026 Bob Herman is the author of Health Care Inc., an award-winning weekly newsletter about the business of health and medicine. Bob Herman[email protected]Bob covers the money in health care, focusing on health insurance and hospitals. His stories delve into Medicare Advantage, opaque prescription drug benefits, and how much executives actually make. He is also the author of the Health Care Inc. newsletter. You can reach Bob on Signal at bobjherman.09. Massachusetts Attorney General Andrea Joy Campbell is suing UnitedHealth Group’s insurance subsidiary, UnitedHealthcare, alleging the company intentionally made low-income older adults appear sicker than they were over the past decade to boost its bottom line. UnitedHealthcare received at least $100 million more than it should have from the Massachusetts Medicaid program due to inflated payments stemming from fraudulent diagnoses, Campbell alleges. Pressure to increase revenue and profit in the Medicaid plan in the state led the company’s top Massachusetts executive to quit, according to the complaint.Advertisement This lawsuit is among the first claiming fraudulent upcoding of Medicare patients who are also enrolled in a state Medicaid plan, but it follows a series of investigations and reports that have shined light on the practice in Medicare Advantage. The allegations in Massachusetts raise the prospect that UnitedHealth and other insurers have been using those same upcoding practices on “dual eligibles” — people who are enrolled in both Medicare and Medicaid — and therefore may command attention from state watchdogs. STAT+ Exclusive Story Already have an account? Log in This article is exclusive to STAT+ subscribers Unlock this article — plus in-depth analysis, newsletters, premium events, and news alerts. Already have an account? Log in Monthly $39 Totals $468 per year $39/month Get Started Totals $468 per year Starter $30 for 3 months, then $399/year $30 for 3 months Get Started Then $399/year Annual $399 Save 15% $399/year Get Started Save 15% 11+ Users Custom Savings start at 25%! Request A Quote Request A Quote Savings start at 25%! 2-10 Users $300 Annually per user $300/year Get Started $300 Annually per user View All Plans To read the rest of this story subscribe to STAT+. Subscribe Log In Health insurance, legal, Medicaid, STAT+, states Submit a correction requestReprints Bob Herman Business of Health Care Reporter Bob covers the money in health care, focusing on health insurance and hospitals. His stories delve into Medicare Advantage, opaque prescription drug benefits, and how much executives actually make. He is also the author of the Health Care Inc. newsletter. You can reach Bob on Signal at bobjherman.09. Newsletter Unpacking the business — and secretive inner workings — of the U.S. health care industry Recommended Breaking News June 1, 2026 STAT Plus: Trump administration releases rules for new Medicaid work requirements Politics May 21, 2026 STAT Plus: Acting head of NIH’s infectious disease institute reported to have stepped down Advertisement Health May 20, 2026 STAT Plus: Kennedy fires two leaders on preventive services task force Health May 20, 2026 STAT Plus: Kennedy names interim surgeon general amid vacancies atop health department Exclusive May 19, 2026 Trump’s cuts to foreign aid are undermining the Ebola response, insiders say Subscriber Picks