Optum Fails Maryland Medicaid Program with Defective Computer System
Maryland Attorney General Anthony Brown has filed a lawsuit against UnitedHealth Group and Optum Inc., alleging they defrauded the state's Medicaid program by supplying a defective computer system. The system, intended for Maryland's behavioral health program, crashed on its first day of use in 2020 and never functioned properly.
According to officials, the crash caused the Maryland Medicaid program to take its system offline for eight months, jeopardizing care for 1.5 million residents enrolled in Medicaid. The program provides mental health and substance abuse care.
AG Brown stated that 'Marylanders in crisis and the providers who care for them rely on Maryland's Medicaid program for essential mental health and substance abuse care.' He added, 'Optum provided a defective system that failed them for years.'
The lawsuit claims Optum's contract with the state spans from 2019 to 2024, with a price tag of $126.9 million. Officials reported that just before the system was set to go live, Optum swapped out its own proprietary software and installed an 'inadequately-tested, inadequately-vetted system' made by a subcontractor.
The platform crashed immediately and couldn't distinguish between medically necessary and frivolous services. Officials also reported that Optum denied legitimate claims, failed to provide receipts, paid providers incorrectly, and didn't prevent widespread multi-million-dollar fraud in areas such as substance abuse treatment and laboratory urine testing.