Chutes & Ladders: MA sues UHG on Medicaid fraud, Teladoc joins Walmart’s Better Care Services, raises for Signos and H1

June 3, 2026 | by | No Comments

It’s another chute for UnitedHealth Group, which hardly needs another. On Friday 29 May, the Massachusetts attorney general sued UnitedHealthcare Community Plans of Massachusetts for misrepresenting and manipulating the health records of members in the MassHealth Senior Care Options (SCO) plans. The objective was to gain higher payments from the Commonwealth of Massachusetts. The fraudulent amount in question is about $100 million. The lawsuit was filed in Suffolk Superior Court.

UnitedHealthcare is the largest provider of SCO plans in Massachusetts. SCO is a state Medicaid program that covers members 65 or older who live in designated areas of the state. Based on a mandatory in-home clinical assessment to determine their health status, covered members are assigned a level of care based on health conditions, with Level 1 being the least serious, Level 2 having behavioral health or substance use disorders, and Level 3 having the most serious health conditions. The levels have correspondingly escalating levels of payment to the plan.

The Commonwealth is stating that members were classified by UnitedHealthcare to Level 2 despite no other diagnosis or treatment. Other patients were assigned to Level 3 through improper assessments. Moreover, United allegedly knew that beginning in 2018 and continuing into 2019, members were improperly assigned to Level 3. United never disclosed the error nor repaid the higher payments resulting from the assignment. 

From the Office of the Attorney General release, “The AGO alleges that these were intentional failures, the result of a ‘growth at all costs’ strategy employed by United that incentivized and encouraged its field nurses to code MassHealth members as sicker or less able than they were.” UnitedHealthcare responded that the fraud allegations and the lawsuit are “meritless” and that “[The complaint] doesn’t accurately describe our Senior Care Options program, which helps seniors with complex care meet their individual health needs.”  MedCityNews, Healthcare Dive  

A nice ladder for Teladoc is the addition of their telehealth services to Walmart’s digital health offerings. Walmart’s Better Care Services will add Teladoc’s telehealth services in virtual urgent care for common conditions, dermatology, and nutrition for their customers. Payment can be either cash pay at $89/visit or through insurance. Prescriptions, if needed, can be sent to a pharmacy, including Walmart’s, which has same-day delivery  in as fast as an hour available in many locations. Walmart added Teladoc’s BetterHelp mental health services in January. Teladoc release, MedCityNews, Healthcare Dive

And funding ladders continue, indicating some freeing up of investment cash for companies that have gone through a few (or more than a few) rounds.

Glucose monitoring system Signos raised a $20 million round. The investment is from GV (Google Ventures), Dexcom, and Blue Cross Blue Shield of Alabama. Funding to date including this round is $57 million.  Signos is also a partner with Dexcom through their direct-to-consumer continuous glucose monitoring website, Stelo.com. Signos’ app for tracking glucose for weight management is FDA-cleared and includes insights into how behavior, lifestyle, sleep, and stress affect weight. It can also detect low and high glucose levels. Membership is $127/month including two sensors a month on the six-month plan. Mobihealthnews, Yahoo Finance

Healthcare provider data and directory company H1 raised $40 million, led by CVS Health Ventures. Across ten lettered and unlettered rounds, funding to date is $233.9 million. It has developed an AI-powered platform for identifying and engaging the right doctor across life sciences, payers, providers, and patients.  The H1 Doctor Graph platform is a structured representation of physician identity, expertise, relationships, and behavioral signals that identifies and engages the right doctors for critical workflows across pharma, health plan, health system, and technology companies. CVS Health and H1 have collaborated on several projects, including an AI model that improved the accuracy of their health care provider directory. Release, Mobihealthnews

Rock Health’s first half funding roundup adjusts the bath temperature to tepid, the bubbles to flat

July 11, 2023 | by

The ‘new normal’ continues, as the bubbles vanish and the poor duck’s feathers are getting soggy and cold. Rock Health’s roundup of digital health funding (US only) continues the chilly flat-to-downward trend to funding. What money and fewer funders are out there which persist in their dedication to healthcare are betting cautiously, minimizing their risk on the table in lower unlabeled funding rounds and pre-vetted concepts. 

  • First half 2023 (H1) funding closed at $6.1 billion across 244 deals. Average deal size was $24.8 million, the lowest since 2019.
  • Breaking down by quarter, Q2 2023 funding hit a new low– $2.5 billion in funding across 113 deals, lower than Q4 2022’s ‘hole’ of $2.7 billion. By comparison, Q1 2023 funding totaled $3.5 billion over 131 deals, adjusted from the earlier report of 132 deals [TTA 5 Apr]. The collapse of three banks, most notably Silicon Valley Bank in March, clearly affected Q2.
  • Given the trend, Rock Health projects that 2023 funding will fall well below 2022, between 2019’s $8.1 billion and 2020’s $14.3 billion

Delving into the numbers:

  • Those ‘generalists’ who jumped into the digital health pool in 2021-22 jumped out. H1’s 555 investors had a 71% repeat rate, meaning that those who knew the water saw some opportunity or put on their wet suits. The overall total dropped from 775 in H1 2022 and 832 in H1 2021.
  • Unlabeled raises were suddenly the way to go. 101 of 244 deals–41%–had no series or round attached. This unprecedented move avoids the spectre of down rounds for companies needing to raise funds–down rounds affect valuation. Interestingly, 67% of these companies’ prior raises were in 2021 and 2022. 37 of them were Series B or lower. 
  • Mega deals inhabit a different territory. H1 had 12 mega deals, 37% of total funding dollars, and was at the 2021 norm of $185 million. Half were at Series D and growth/PE. They clustered in value-based care, non-clinical workflow, and that former mouse in the pumpkin coach, in-home and senior care. This level of funding also gravitated to the pre-vetted: incubated by VCs included Paradigm (clinical trials) and Monogram Health (kidney care).  Recently funded Author Health, long in stealth, will operate in a narrow slice of mental health funded by Medicare plans.
  • Zero IPOs, but acquisitions and shutdowns/selloffs continue. Acquisitions continued on a track of about a dozen per month, down from 2022’s average of 15. On the gloomier side, quite a few companies simply ran out of runway after raising a little or a lot of funding. These hit the lights at the end resulting in hull loss: Pear Therapeutics, SimpleHealth, The Pill Club, Hurdle, and Quil Health. If they were lucky, they had intellectual property worth something to someone–Pear to four buyers including a former founder, 98point6’s AI platform business to Transcarent–or subscriber bases worth acquiring, such as Pill Club to Nurx, SimpleHealth to TwentyEight Health. This does not count Amazon shuttering Halo and leaving subscribers in the lurch. (Nor Amazon’s dodgy approach to privacy getting Federal and private scrutiny, which this Editor explores here and here.)

To this Editor, 2023 will be a ‘grind it out and survive’ year for most health tech and digital health companies. Survivors will carefully tend their spend, their customers (who will be doing their own cutbacks), and watch their banks. The signature phrase this year was written in 1950, another uncertain time, by Joseph L. Mankiewicz and uttered with flair by Bette Davis in a classic film about the theatre, ‘All About Eve‘: “Fasten your seatbelts; it’s going to be a bumpy night.”   Rock Health Insights