A 'Voluntary' Organization Quietly Became Medicaid's Third-Largest Billing Entity at $5.6 Billion

Tempus Unlimited, Inc., headquartered in Stoughton, Massachusetts, has billed $5.57 billion to Medicaid since January 2018. That makes it the third-highest paid entity in the entire national Medicaid dataset — behind only state agencies and major managed care organizations. It's classified in the NPPES registry as a 'Voluntary or Charitable' organization.

The billing profile tells a focused story: 98.05% of Tempus's $5.57 billion — or $5.46 billion — comes from code T1019, personal care services. The organization has processed 63.5 million claims for 3.35 million beneficiary-records over 84 months of continuous billing. Like FreedomCare in New York, Tempus operates as a fiscal intermediary, processing caregiver payments under Massachusetts' consumer-directed care programs.

The growth trajectory is notable. From January 2018 monthly billing of approximately $34 million for T1019 alone, Tempus's monthly revenue has grown steadily. With 3.35 million beneficiary-records (which includes repeat enrollees across months), the organization touches a significant share of Massachusetts' Medicaid population through personal care services.

Tempus also operates under a second NPI (1275752065) with the same authorized official, CEO Larry Spencer, and the same address at 600 Technology Center Drive in Stoughton. Combined billing across both NPIs could exceed $6 billion, making the full entity potentially the second-largest billing operation in the dataset. The use of multiple NPIs for what appears to be a single organization raises questions about billing structure and oversight.

The 'Voluntary or Charitable' classification alongside $5.57 billion in Medicaid receipts creates a striking contrast. While the classification reflects the organization's legal structure, the scale of taxpayer funds flowing through this entity suggests that scrutiny proportional to its size is warranted. Massachusetts auditors should examine whether the oversight infrastructure matches the $800+ million per year in claims processing.