A Massachusetts woman has pleaded guilty in federal court in connection with a $100 million home healthcare fraud scheme. Winnie Waruru, 42, of Lowell, pleaded guilty on Sept. 8, 2022, to one count of conspiracy to commit healthcare fraud; one count of healthcare fraud — aiding and abetting; one count of conspiracy to pay and receive kickbacks; two counts of making false statements; and one count of making a false statement in a healthcare matter. Waruru was arrested and charged along with co-defendant Faith Newton in February 2021. Newton has pleaded not guilty and is pending trial. According to the indictment, from January 2013 to January 2017, Newton was part owner and operator of Arbor Homecare Services LLC. Waruru was a Licensed Practical Nurse employed as a home health nurse at Arbor. Waruru and, allegedly, Newton engaged in a conspiracy to use Arbor to defraud MassHealth and Medicare of at least $100 million by committing healthcare fraud and paying kickbacks to induce referrals. Newton then allegedly laundered the ill-gotten gains.
Specifically, it is alleged that Arbor, through Newton and others, including Waruru, failed to train staff, billed for home health services that were never provided or were not medically necessary and billed for home health services that were not authorized. Arbor, through Newton and others, developed employment relationships as way to pay kickbacks for patient referrals, regardless of medical necessity requirements. They also allegedly entered sham employment relationships with patients’ family members to provide home health aide services that were not medically necessary and routinely billed for fictitious visits that did not occur. As alleged in the civil complaint, Newton either directly or through Arbor, targeted particularly vulnerable patients who were low-income, on disability and/or suffering from depression and/or addiction. Waruru and Arbor billed MassHealth for Waruru’s skilled nursing visits, many of which she did not perform, were medically unnecessary, or were not approved by a physician. Waruru was personally responsible for causing Arbor to bill MassHealth for over $1.2 million in skilled nursing visits, much of which was fraudulent. Waruru also passed cash payments allegedly from Newton to two Arbor patients to retain those patients.
