2026-05-29 14:15:09 UTC / 路透社
*2020年4月13日，美国加利福尼亚州圣安娜，联合健康集团旗下保险子公司联合健康保险的企业标识出现在其中一栋办公楼外。 路透社/迈克·布莱克
5月29日——马萨诸塞州周五起诉联合健康旗下一家保险子公司，指控该公司通过夸大老年患者病情严重程度，骗取该州医疗补助计划超1亿美元资金。
马萨诸塞州总检察长安德里亚·乔伊·坎贝尔表示，以“马萨诸塞州联合健康社区计划”名义运营的联合健康保险，曾虚报其参保的老年护理选择计划参保人员的健康状况，以此获取更高额的医保拨款。
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联合健康集团在一份声明中称该诉讼“毫无根据”。
坎贝尔指控联合健康在2015年至2025年间，为65岁及以上患者提交虚假诊断信息，以此从马萨诸塞州医疗补助计划处骗取更高拨款，并推行该公司“不惜一切代价追求增长”的战略。
此次诉讼指控联合健康提交虚假索赔并获取不当利益。该诉讼要求追回马萨诸塞州医疗补助计划不当支付的资金，并要求三倍赔偿。
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Massachusetts sues UnitedHealth unit for allegedly defrauding Medicaid program
2026-05-29 14:15:09 UTC / Reuters
The corporate logo of UnitedHealthcare, the insurance unit of UnitedHealth Group, appears on the side of one of their office buildings in Santa Ana, California, U.S., April 13, 2020. REUTERS/Mike Blake
May 29 – 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.
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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
Our Standards: The Thomson Reuters Trust Principles.
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