Massachusetts officials have referred a dozen home health agencies to the attorney general's Medicaid Fraud Division, calling for an investigation of potentially fraudulent billing practices, according to The Boston Globe.
Although officials did not say what kind of fraudulent payments they have concerns about, the referral was driven by an 82 percent spike in home health spending within MassHealth, which oversees the state's Medicaid program. The majority of that spike has been attributed to 62 companies that began operating in 2013. Just last year, a state audit revealed MassHealth had paid more than $500 million in improper payments traced back to duplicative claims through managed care plans.
An attorney general spokeswoman told The Globe that the office was "taking a hard look at the home health industry," with a specific focus on fraudulent payments.
Some providers, like Compassionate Homecare Inc. in Worcester, have already faced backlash. The provider filed suit in January claiming MassHealth had inappropriately withheld $3.2 million in payments following unidentified fraud allegations.
The home health industry has been the frequent target of fraud investigations nationwide. Recently, home health owners in Florida, New Jersey and Texas were caught in fraud schemes that stole as much as $57 million. In response, prosecutors have sought stiff penalties, with some physicians and owners facing more than six years in prison.
To learn more:
- here's the Boston Globe article