# Massachusetts AG Settles Nursing Facility Fraud Case

Massachusetts Attorney General Andrea Joy Campbell announced a **$1 million settlement** with RegalCare Management for manipulating patient health assessments to fraudulently increase Medicare and MassHealth reimbursements. The settlement resolves allegations that RegalCare inflated Resource Utilization Group (RUG) and Management Minute Questionnaire (MMQ) scores, undermining the integrity of public health programs. This enforcement action highlights the state's commitment to combating healthcare fraud and protecting public funds.

- **Why this matters:** Procurement professionals should be aware of increased scrutiny on healthcare providers receiving public funds, emphasizing compliance and accurate reporting in Medicaid and Medicare billing.
- The settlement signals potential risks for contractors and operators in the nursing facility sector regarding reimbursement practices.
- Organizations involved in healthcare procurement in Massachusetts may face tighter oversight and should ensure robust internal controls to prevent fraudulent claims.
- Vendors and contractors can expect continued enforcement collaboration between state and federal agencies, including the Massachusetts Attorney General's Office and HHS.

**Jurisdictions:** sled
**Industries:** Healthcare
**Topics:** Regulatory Compliance
**Published:** September 24, 2026

### Government Entities
- Office of the Attorney General
- U.S. Attorney’s Office for the District of Massachusetts (USAO)
- MassHealth
- Department of Public Health
- U.S. Department of Health and Human Services (HHS)

### Vendors
- RegalCare Management 2.0 LLC (operator of nursing facilities)
- RegalCare Management Group, LLC (operator of nursing facilities)

### Key Quotes
> When nursing facilities falsify patient records and assessments to make more money off Medicare and MassHealth, it threatens the integrity of these essential programs that our most vulnerable residents rely on.
> — Andrea Joy Campbell, Attorney General

### Sources
- [AG Campbell Announces $1 Million Settlement With Nursing Facility Operator RegalCare For Medicare And Medicaid Price Hike Scheme | Mass.gov](https://www.mass.gov/news/ag-campbell-announces-1-million-settlement-with-nursing-facility-operator-regalcare-for-medicare-and-medicaid-price-hike-scheme) - MA