News  Brockton Adult Foster Care Provider Resolves Allegations of MassHealth Fraud

Boston — Victory Human Services Inc. (Victory) will pay more than $548,000 to resolve allegations that it fraudulently charged the state’s Medicaid program (MassHealth) for Adult Foster Care (AFC) services, Attorney General Maura Healey announced today. 

“It’s critically important that our MassHealth providers are honest about the services they provide,” said AG Healey. “This settlement with Victory will help ensure that our health care resources serve the people most in need.”

MassHealth pays for medically necessary AFC services when a qualified caregiver lives in a residence with the MassHealth member.

The AG’s Office alleged that, in 2013 and 2014, Victory knowingly and fraudulently billed MassHealth for AFC services even though some of its caregivers were not living with MassHealth members. Victory also failed to maintain documentation to support the level of AFC services for which it billed MassHealth.

Under the terms of the settlement, Victory will pay $548,410.16 to resolve these allegations, and has also agreed to comply with all federal and state laws and regulations governing MassHealth moving forward.

In the AG’s Office, this matter was handled by Assistant Attorneys General Kevin Lownds, Jay McCormack, and Gregoire Ucuz and Investigator Eli Ward, all of the AG’s Medicaid Fraud Division. This matter was referred to the AG’s Office by MassHealth, and MassHealth provided critical support to this investigation.