Worcester agency charged with defrauding Medicaid out of $816K
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Attorney General Maura Healey has indicted Compassionate Homecare and four individuals with defrauding Medicaid.
Worcester-based Compassionate Homecare and three individuals have been indicted in connection with allegations that they stole hundreds of thousands of dollars from the state’s Medicaid program, Attorney General Maura Healey announced Friday.
The home health agency allegedly routinely overbilled and falsely billed for services that were not authorized or provided to patients, according to a release from Healey’s office.
MassHealth provides healthcare products and services to eligible low-income individuals, including people with disabilities, children and senior citizens. CHC is headquartered in Worcester with branch offices in West Springfield and Lawrence. It was established to provide home health services to individuals covered by the MassHealth program, including skilled nursing and home health aide (HHA) visits, according to the AG’s office.
Compassionate Homecare, Inc. (CHC), owner Francis Kimaru, chief operating officer Wilberto Rodriguez, and administrator Deborah Giordano were indicted on Thursday by a Statewide Grand Jury on the following charges:
Compassionate Homecare
- Larceny by False Pretense (4 counts)
- Medicaid False Claims (5 counts)
Francis Kimaru, 41, North Grafton, MA
- Larceny by False Pretense (1 counts)
- Medicaid False Claims (2 counts)
Wilberto Rodriguez, 31, Norwich, CT
- Larceny by False Pretense (2 counts)
- Medicaid False Claims (3 counts)
Deborah Giordano, 57, West Greenwich, RI
- Larceny by False Pretense (1 count)
- Medicaid False Claims (2 counts)
The AG’s Office began an investigation after a physician complained that CHC was seeking authorization to provide services, through “phony” referral forms, for patients who had no medical need for home health services. The AG’s investigation allegedly revealed that from 2011 to February 2016, CHC billed MassHealth through numerous fraudulent schemes.
Investigators allege that CHC recruited a significant number of patients who required no health-related services and who were fully capable of performing their own activities of daily living. CHC also allegedly billed for services that it never provided to MassHealth members, including instances where the company billed for home health services while members were at inpatient facilities.
As a result of its investigation to date, the AG’s Office has identified $815,588.61 that MassHealth paid CHC for services that were either not authorized or never provided.
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