- Office of Attorney General Maura Healey
Media Contact for AG Secures Settlements with Two Adult Day Health Centers over Allegations of Improper Billing
Boston — Attorney General Maura Healey announced today that two adult day health centers in Boston and Dartmouth will pay more than $186,000 to resolve allegations that they improperly billed the state’s Medicaid Program (MassHealth).
Fuente De Vida Adult Day Care Services, LLC (Fuente) of Boston and La Bella Vida Adult Day Health Services, LLC (La Bella Vida) of Dartmouth will pay $186,310 to resolve allegations that the companies improperly billed MassHealth for time periods when members were not receiving services from either Fuente or La Bella Vida. The Attorney General’s Office also alleges that, since 2014, both companies billed MassHealth for services while members were in an inpatient nursing facility or hospital. Both facilities are owned and operated by Vadim D. Binder of Dover.
“False and improper billing results in the misappropriation of vital health care resources,” said AG Healey. “We expect companies to abide by our state billing regulations and laws to ensure that MassHealth money is spent to support necessary care for low-income members.”
In addition to the financial settlement, both facilities will agree to contract, at their expense, with an independent compliance monitor who will conduct regular audits and oversee updated policies and procedures and annual training of employees. This case was referred to the AG’s Office by MassHealth.
The AG’s Office has resolved previous cases of improper billing at adult day health facilities. In November 2019, AG Healey secured a settlement with an adult day health facility in Springfield, recouping nearly $275,000 for MassHealth for improper billing. In November 2018, three adult day health facilities agreed to pay more than $500,000 to settle allegations that they too engaged in improper billing.
This matter was handled by Managing Attorney Kevin Lownds, Assistant Attorney General Ali Russo, Senior Healthcare Fraud Investigator Aleksandra Andriyevskaya, and Investigator Johan Gonzalez, all of AG Healey’s Medicaid Fraud Division, with substantial assistance from MassHealth. The Medicaid Fraud Division 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.