- Office of Attorney General Maura Healey
Media Contact for Owner of Home Health Agency Arrested for $2.7 Million MassHealth False Billing Scheme
Boston — The owner of a Massachusetts home health agency has been arrested in connection with allegedly stealing approximately $2.7 million from the state’s Medicaid program (MassHealth) by routinely overbilling and falsely billing for services that were not authorized, Attorney General Maura Healey announced today.
Hellen Kiago, age 47, of Sturbridge, was arrested this morning by Massachusetts State Police assigned to the AG’s Office. A Statewide County Grand Jury returned indictments against Kiago and her company, Lifestream Healthcare Alliance, LLC on Sept. 28. A warrant for Kiago was subsequently issued.
Kiago was indicted on charges of Medicaid False Claims (5 counts) and Larceny over $250 by False Pretenses (1 count). Lifestream was indicted on the same charges.
Kiago and Lifestream were arraigned today in Worcester Superior Court where they pleaded not guilty to the charges. Judge Janet Kenton-Walker set bail at $100,000 cash for Kiago, with the conditions of release that she surrender her passport and call the Probation Department weekly. The defendants are due back in Worcester Superior Court on Dec. 6 for a pre-trial conference.
Lifestream is a home health agency with offices located in Worcester and Dracut and Kiago is the sole owner. The agency was established to provide home health services to individuals covered by the MassHealth program, including skilled nursing and home health aide visits.
The AG’s Office began an investigation after receiving complaints from several former employees alleging misconduct and fraudulent billing practices.
The indictments allege that since at least July 2015, Kiago, through Lifestream, billed MassHealth for home health services allegedly provided to patients that were not authorized by a physician, billed far in excess of the hours a physician had authorized, or retained overpayments received from MassHealth.
Specifically, the indictments allege that the defendants allegedly billed MassHealth for services that were not authorized by physicians and that Kiago instructed an employee to forge physician signatures on certain patient plans of care that were unsigned.
The AG’s Office alleges that on numerous instances, Lifestream aides submitted more hours on their timesheets for services provided than what was listed in the corresponding plan of care. Kiago also allegedly personally directed employees to provide patients with hours beyond those deemed medically necessary by the clinician in the field.
The AG’s Office further alleges that in 2016, Kiago hired additional staff to undertake an internal audit that resulted in falsification of documents so that paperwork would be correct for an upcoming accreditation audit.
Based on these various schemes, the AG’s Office alleges that the defendants defrauded MassHealth of approximately $2.7 million dollars.
MassHealth provides healthcare products and services to eligible low-income individuals, including people with disabilities, children and senior citizens.
All of these charges are allegations and defendants are presumed innocent until proven guilty.
This matter was handled by Assistant Attorneys General Nita Klunder and Alexandra Brazier and Investigators Erica Schlain, Denise Long and Mirlinda Sejdiu, all of AG Healey’s Medicaid Fraud Division, with assistance from the Massachusetts State Police assigned to the AG’s Office, Special Agents from the Department of Health & Human Services, Office of the Inspector General, and Victim Witness Advocate Ellen Davis of the AG’s Victim Services Division. MassHealth also provided assistance during this investigation.