Press Release  Audit Finds Overpayments to Franklin-based Business by MassHealth

Boston — Auditor Suzanne M. Bump today released an audit of Hudson Home Health Care, a provider of durable medical equipment, which found that improper billing practices resulted in $557,006 in overpayments from MassHealth for wheelchair components.

“MassHealth has policies and rates in place to ensure that they get the best rate for medical equipment. This provides significant savings to the people of Massachusetts,” Bump said. “However, when these policies and rates are not enforced, taxpayers are left on the hook. During our audit, MassHealth informed us that they recognize this problem and expressed a commitment to addressing this issue.”

Under Massachusetts regulations, vendors are required to bill MassHealth at the lowest price that they charge to any payer for most wheelchair components, such as headrests and back cushions. The audit found that the majority of the overpayments, $474,486, were a result of Hudson not billing MassHealth at the lowest possible rate for those wheelchair components. 

In addition, Hudson was overpaid by approximately $82,520 for wheelchair components for which pricing was not clearly defined and which were individually priced by MassHealth. For these components, the vendor is required to provide MassHealth with a final invoice for their costs, which includes any discounts they received, so MassHealth can determine the appropriate reimbursement rate. The audit found that Hudson received payments for incorrectly applied discounts, did not disclose all discounts, or submitted claims with clerical errors that resulted in an incorrect reimbursement.

MassHealth agreed with Bump’s findings, and plans to work with Hudson to identify potential recoupment opportunities for these funds and take steps to prevent similar overpayments in the future.

Today’s audit follows an audit conducted by Bump’s office last year which found a total of $4 million in improper payments made to vendors by MassHealth for wheelchairs and wheelchair components. The current audit of Hudson was conducted to quantify the effect of the billing irregularities identified by the previous audit. Hudson was selected for an audit due to the significant number of payments they received from MassHealth for wheelchair components.

Hudson Home Health Care, a provider of durable medical equipment, is located in Franklin, Massachusetts, and is a major supplier of seating and mobility equipment in the Northeast.

Massachusetts receives a reimbursement from the federal government for 50 percent of most services provided to MassHealth members. MassHealth expenditures account for roughly 38 percent of the state’s total annual budget.

The Hudson Home Health Care audit is available here.

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