BOSTON — Attorney General Maura Healey announced today that a Worcester adult day health provider will pay $195,000 to resolve allegations that it improperly billed the state’s Medicaid program, MassHealth, for services.
Worcester Adult Day Care Center (WADCC) has also agreed to enter into a
three-year independent compliance monitoring program to ensure it is complying with state and federal laws and regulations.“False and improper billing to MassHealth takes away critical funds from programs that provide health care to some of our most underserved populations,” said AG Healey. “We are pleased to return these funds back to the state and hold this company accountable.”
On the basis of an investigation by the AG’s Medicaid Fraud Division, WADCC allegedly overbilled MassHealth for the number of people served and the number of hours care was provided, reporting that more people were provided care on a given day than actually received services. The AG’s Office also alleges that WADCC employed the incorrect billing code for some members who did receive services, charging MassHealth for a full day of services when the individuals only attended for a couple of hours and a lower billing code was required.
This matter was handled by Assistant Attorney General Philip Schreiber and Investigators Julia Galvao and William Welsh of the AG’s Medicaid Fraud Division. MassHealth provided substantial assistance with the investigation.
The Medicaid Fraud Division receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award. The remaining 25 percent is funded by the Commonwealth of Massachusetts.
No comments:
Post a Comment