Press Release  Audit Shows MassHealth Making Inappropriate Payments for Adult Foster Care Services to Worcester Provider

Boston — Today, State Auditor Suzanne M. Bump released an audit showing that MassHealth has made more than $300,000 in inappropriate payments for adult foster care (AFC) services to Centro Las Americas Inc., a Worcester-based human-services provider. These payments were for services that were duplicative of services that clients received through the Home Health Program from other providers. Both services were paid for by MassHealth. The audit examined Centro’s activities from July 1, 2013 through June 30, 2015.

State regulations prohibit MassHealth from paying for AFC services when a member is receiving any other personal care services, including skilled nursing care and home health aides. Despite these regulations, in an email to AFC providers on September 15, 2014, MassHealth’s then-director of the Office of Long-Term Services and Supports informed these providers that they would in-fact pay for certain home care services to AFC members.

“The payments for duplicative services to Centro Las Americas are concerning, but more concerning are the patterns of systemic problems in the payment process at MassHealth,” Bump said. “This audit shows that once again, MassHealth is not only ignoring their own regulations, but also directing providers to disregard them as well. These regulations ensure transparency and accountability on how public dollars are spent, and cannot be ignored in favor of rule-making by email outside of the public view.”

In July, Bump released an audit of MassHealth’s paid claims within the AFC and Group Adult Foster Care (GAFC) programs, which found that MassHealth sent a similar email to AFC and GAFC providers indicating that it would pay for these services for individuals living in rest homes, despite similar regulations prohibiting these payments.

The audit also found that Centro used $57,341 in state funds for unallowable expenses including trips to Puerto Rico for investigating an opportunity to develop a new revenue stream, golf outings, meals without proper documentation, and gifts. In addition, it noted that Centro did not use a competitive procurement process when it purchased a vehicle for its CEO. To rectify these problems, Bump recommends the entity reimburse the state for funds that were spend inappropriately, and amend or develop policies to ensure funds are spent properly and large purchases follow proper procurement procedures.

Centro Las Americas Inc. was founded in 1977 as a not-for-profit human-services agency. Beyond AFC services, they also offer family support, eldercare, behavioral-health care, and child and family services. Approximately half of its funding comes from contracts with state agencies.

The Centro Las Americas Inc. audit is available here.

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