Over the past few weeks, government officials have seemingly restarted their aggressive oversight of Medicare-certified home health agencies.
For much of 2020, government watchdogs took a measured approach to health care oversight and enforcement, allowing operators to focus their efforts on COVID-19 mitigation instead of paperwork and compliance. But multiple settlements and charges have been made recently.
On Friday, for example, Massachusetts Attorney General Maura Healey announced that her office reached a $10 million settlement with a Lawrence-based home health care company and its owner to resolve allegations that they falsely billed MassHealth for unauthorized services.
Under the terms of the settlement, Maestro-Connections Health Systems LLC and its CEO will pay $10 million to resolve allegations that — from January 2014 through August 2019 — the provider knowingly submitted false claims to MassHealth and the state’s managed care entities for home health services that had not been appropriately authorized by a physician.
Maestro has locations in Lawrence, Auburn, Athol, Framingham, Taunton, Holyoke and Lynn, according to the attorney general’s office.
“Companies like Maestro that defraud MassHealth take vital resources away from the program and the people who need them most,” Healey said in a statement. “Since 2016, my office has recovered $40 million for MassHealth by combating fraud, waste and abuse in the home health industry. Our work continues to ensure health care dollars are spent appropriately.”
Source: Home Healthcare News