Press Release  AG Healey Secures $430,000 From Springfield Home Health Agency To Resolve Fraudulent Billing Allegations

BOSTON — Attorney General Maura Healey announced today that her office has reached a $430,000 settlement with a Springfield-based home health care company and its CEO to resolve allegations that they falsely billed the state’s Medicaid program, MassHealth, for services that had not been appropriately authorized by a physician.

According to the AG’s Office, Allied Health Systems (Allied) in Springfield and its CEO Henry Azzun submitted false and/or fraudulent claims to MassHealth and managed care entities administering benefits for MassHealth members for services that had not been appropriately authorized by a physician.

“By accepting MassHealth funds, home health agencies agree to abide by the regulations and standards set by the state,” 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 Allied began following a referral by MassHealth. To bill MassHealth for home health services, the member’s physician must review, sign, and date a plan of care every 60 days and certify that the services are medically necessary. Home health agencies are required to maintain medical records for at least six years after the date of medical services. The AG’s Office found that Allied billed for services for which it did not have valid plans of care signed by a physician.

In addition to the financial payment, the settlement also includes a requirement that Allied must operate under a three-year compliance program overseen by an independent compliance monitor. That program will include updated policies and procedures, new training for staff, and yearly on-site audits conducted by the monitor. Allied will pay for the compliance monitoring program.

This 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 agencies and their owners and settled civilly with 14 home health agencies, an effort which has returned more than $50 million to MassHealth. In May 2022, a Tewksbury home health agency, Integrity Home Care Solutions, LLC, and its owners agreed to pay $550,000 to resolve allegations that Integrity had not complied with MassHealth plan-of-care requirements. In March 2022, a Worcester home health company, Compassionate Homecare, Inc., reached a $6.53 million settlement to resolve longstanding litigation with the AG’s Office concerning its noncompliance with MassHealth regulations. In December 2021, Chicopee-based Home Care VNA and its owners reached a $630,000 settlement to resolve allegations that the agency billed the state for services not appropriately authorized by a physician.

This matter was handled by Assistant Attorney General Gregoire Ucuz and Investigator Will Welsh of the AG’s Medicaid Fraud Division, with substantial assistance from MassHealth.

The Medicaid Fraud Division of the Massachusetts Attorney General’s Office receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award. The remaining 25 percent is funded by the Commonwealth of Massachusetts.

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