A home health agency and its owners will pay $1.2 million and enter into a comprehensive compliance program to resolve allegations that they falsely billed the state’s Medicaid Program (MassHealth), Attorney General Maura Healey announced today. The settlement with Independent at Home in Brockton and its owners, Loretta Ihedioha and Corona Robinson, resolves allegations that, since December 2013, they knowingly submitted false claims to MassHealth and managed care entities (MCEs) administering services to MassHealth members for home health services that had not been appropriately authorized by a physician. Independent also allegedly submitted false claims for home health services that it did not provide, as members were residing in inpatient facilities at the time Independent billed for services.
According to the AG’s Office, Independent, Ihedioha, and Robinson knew that they had inappropriately received payments as a result of their submission of false claims, but made no attempt to notify MassHealth or return any money. As part of the settlement, in addition to a payment of $1.2 million, the company also agreed to implement a three-year compliance program. The program will be overseen by an independent compliance monitor, paid for by Independent, and will include updated policies and procedures and staff training to ensure compliance with MassHealth regulations. The independent compliance monitor will also conduct annual onsite audits and report deficiencies and overpayments to the AG’s Medicaid Fraud Division.
