BOSTON — A Tewksbury-based home health care company and its owners will pay $550,000 to resolve allegations that they billed the state’s Medicaid program, MassHealth, for services that had not been appropriately authorized by a physician, Attorney General Maura Healey announced today.
According to the AG’s Office, Integrity Home Care Solutions, LLC, a home health agency, and its owners, President and CEO Joseph W. Kimani and Vice President Beatrix Fingfing, failed to comply with MassHealth regulations that require a provider to obtain physician authorization confirming the services are medically necessary before submitting claims to MassHealth.
“Home health agencies have an obligation to play by the rules and ensure that their services are medically necessary,” said AG Healey. “Many MassHealth members rely on the program to access needed care, which is why our office will continue to take action against false billing.”
Under the terms of the agreement, Integrity and its owners agreed to pay $550,000 back to MassHealth and implement a three-year compliance program, overseen by an independent compliance monitor, that will require Integrity to establish updated policies, procedures, and trainings to ensure compliance with MassHealth regulations and will conduct annual on-site audits.
Today’s settlement is part of a larger effort by AG Healey and MassHealth to combat fraud in the home health industry. Since 2016, the AG’s Office has successfully prosecuted three home health...
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