- Office of Attorney General Maura Healey
Media Contact for AG Healey Secures $550,000 from Home Health Care Company to Resolve False Billing Allegations
Thomas Dalton, Deputy Press Secretary
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 agencies and their owners and settled civilly with 13 home health agencies, returning approximately $50 million to MassHealth. 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 January 2022, a Chicopee-based home health agency, Home Care VNA, agreed to pay $630,000 to resolve allegations of fraudulent billing. In December 2020, Maestro-Connections Health Systems, LLC agreed to pay $10 million to resolve allegations that it fraudulently submitted claims for unauthorized services.
This matter was handled by Assistant Attorney General Matthew Jones, Senior Health Care Fraud Investigator Christine Barker, and Investigator Julia Galvao, 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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