Corporate Compliance

10 face Medicare fraud charges in Massachusetts

Compliance Monitor, October 5, 2011

Three Massachusetts grand juries have indicted 10 individuals for allegedly intentionally submitting false claims totaling approximately $10 million to MassHealth, the state attorney general announced recently. MassHealth, which combines the national Medicaid program and Children’s Health Insurance Program into one comprehensive program, provides health insurance for low-to medium-income residents of Massachusetts.

Prosecutors allege that defendants overstated the care required for some patients, billed for deceased patients, or participated in kickback schemes.

“Fraud committed against the Medicaid system is theft from taxpayers, plain and simple. It also takes away much-needed funds that are supposed to go to care for some of our most vulnerable patients,” Massachusetts Attorney General Martha Coakley said in a press release.

One case alleges that three employees of Adlife Healthcare, LLC, in Framingham, MA, billed MassHealth for approximately $5.5 million in at home personal care services that the company did not render. It further alleges that the employees destroyed internal documents and falsified records in an effort to hide the scheme from investigators.

Read more on the official Attorney General of Massachusetts website.

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