- Office of Attorney General Maura Healey
Media Contact for AG Healey Secures $630,000 From Home Health Care Company to Resolve False Billing Allegations
Thomas Dalton, Deputy Press Secretary
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.
Ogutt and Lubega also own Altranais Home Care, a home health care company that agreed to pay $3.1 million in 2020 to settle similar allegations by of falsely billing MassHealth.
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 eleven home health agencies, an effort which has returned more than $42 million to MassHealth. In November 2021, Independent at Home, a Brockton home health agency, agreed to pay $1.2 million to resolve allegations that it failed to comply with the plan-of-care requirement. In March 2021, Lifod Home Health Care LLC agreed to pay $1.25 million to resolve similar allegations of false billing, and in December of 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 Gregoire Ucuz and Investigator Heather Dwyer of the AG’s Medicaid Fraud Division, with substantial assistance from MassHealth, the Massachusetts Medicaid and Children's Health Insurance Program.
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.