Attorney General Maura Healey announced that her office has reached a $430,000 settlement with a Springfield-based home healthcare company and its CEO to resolve allegations that they falsely billed the state’s Medicaid program, MassHealth, for services that had not been appropriately authorized by a physician. According to the AG’s Office, Allied Health Systems (Allied) in Springfield and its CEO Henry Azzun submitted false and/or fraudulent claims to MassHealth and managed care entities administering benefits for MassHealth members for services that had not been appropriately authorized by a physician.
The AG’s investigation into Allied began following a referral by MassHealth. To bill MassHealth for home health services, the member’s physician must review, sign, and date a plan of care every 60 days and certify that the services are medically necessary. Home health agencies are required to maintain medical records for at least six years after the date of medical services. The AG’s Office found that Allied billed for services for which it did not have valid plans of care signed by a physician. In addition to the financial payment, the settlement also includes a requirement that Allied must operate under a three-year compliance program overseen by an independent compliance monitor. That program will include updated policies and procedures, new training for staff, and yearly on-site audits conducted by the monitor. Allied will pay for the compliance monitoring program.
