Insurer accused of making patients appear sicker to inflate payments.
filing a complaint in Suffolk Superior Court accusing health insurer United Healthcare of submitting more than $100 million in fraudulent claims to MassHealth.
The allegations, if proven, represent a huge breach of public trust by the insurer — and highlight one reason why many people are skeptical of both our country’s health care system and its social safety net.
As Campbell told reporters in a press call, when a company commits Medicaid fraud, “that erodes public trust in the institutions designed to help those in need.” And when people lose trust in health care, they’re less likely to…
This type of fraud targets the supply chain and accounts payable departments of businesses.
- Invoice Manipulation: Criminals intercept a legitimate invoice between a supplier and a client and change the banking details to their own. The client pays the bill thinking they are paying their trusted vendor.
- Kickbacks and Bribery: A vendor secretly pays an employee of the purchasing company to ensure their bid is successful or to overlook inflated pricing.