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Home Care Service Providers Accused of Cheating Medicaid

  • Massachusetts AG Maura Healey sued home health agency Prestige Health Care Services, Inc. and related individuals (collectively “Prestige Health”) over allegations that Prestige Health falsely billed the state’s Medicaid program in violation of the Massachusetts False Claims Act and the Medicaid False Claims statute.
  • The complaint alleges, among other things, that Prestige Health billed MassHealth for services that were not authorized by a physician, and that it continued to provide services to patients after they were no longer medically necessary. The complaint seeks treble damages and civil penalties.
  • AG Healey also reached a settlement with home health agency Independent at Home, LLC and its owners (collectively “Independent”) to resolve allegations that Independent knowingly submitted false claims to MassHealth for services not properly authorized by a physician and for services it did not provide. According to the AG’s office, under the terms of the settlement, Independent agreed to pay $1.2 million to the state and to implement a comprehensive compliance program monitored by an independent monitor who will conduct annual on-site audits, among other things.