BOSTON — As part of ongoing efforts to combat fraud in the home health industry, Attorney General Maura Healey announced today that her office reached a $630,000 settlement with a Chicopee-based home health care company and its owners to resolve allegations that they billed the state’s Medicaid program, MassHealth, for services that had not been appropriately authorized by a physician.
According to the AG’s Office, Home Care VNA and its owners Constant Ogutt and Shakira Lubega failed to ensure that claims submitted to MassHealth complied with a plan-of-care requirement certifying the services as being medically necessary. Home Care VNA, Ogutt, and Lubega also allegedly knew that they had received overpayments from the state as a result of their submission of claims but made no attempt to notify or return any overpayments to MassHealth.
“Home health care agencies that accept state funds must be held to high standards of transparency and integrity,” said AG Healey. “Our office will continue to protect the MassHealth program and make sure that it is not being billed for medically unnecessary services.”
The AG’s investigation into Home Care VNA began following a referral by MassHealth. To bill MassHealth for home services, the member’s physician must review and sign a plan of care. Home health agencies are required to maintain updated medical records of medically necessary services provided to each member for at least six years after the date they were first administered.
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