By Kerry Feltner
The state’s Medical Fraud Division recovered over $45 million for MassHealth—the state’s Medicaid program—in fiscal year 2020, including over $230,000 from a Waltham employee.
Meadow Green Nursing Home’s former admissions director, Christina Polcari, 54, was indicted last month in an alleged embezzlement scheme that misappropriated the funds. Polcari, a Belmont resident, was indicted for larceny over $1,200 (one count), forgery (five counts), and embezzlement by fiduciary (one count) on Sept. 14.
The Medicaid Fraud Division is responsible for reviewing complaints of abuse, neglect, mistreatment, and financial exploitation of patients in long-term care facilities, according to the Attorney General’s Office. It secured 27 civil settlements with various entities, including home health agencies, mental health centers, ambulance providers, and individual doctors and practices this year.
An additional 11 providers and individuals were criminally charged for defrauding MassHealth and three individuals were criminally charged with abuse, neglect, or financial misappropriation in long-term care facilities, according to the office.
“I am proud of the work our Medicaid Fraud Division does each day on behalf of vulnerable residents in Massachusetts, taxpayers, and to protect the integrity of MassHealth,” said Attorney General Maura Healey, in a statement. “Each year, the Division returns tens of millions of dollars to the state, ensures important health care funds are spent appropriately, and continues to be a national leader in this space.”
Below is a breakdown of the work of the division this year, compiled in a statement by the AG’s office:
• In December 2019, two individuals, John and Joanne Wachira, and their company, Petra Healthcare, LLC, were indicted in connection with a scheme to falsely bill MassHealth while exploiting homeless individuals.
• In December 2019, a Brighton adult foster care company, Absolute Care, Inc., agreed to pay $3 million to resolve allegations that it had falsified caregiver timesheets and submitted claims for dates on which care was not provided.
The Division also recovered $450,000 in April 2020 from an Avon-based home health company, Brigham Home Care Services, over allegations that it violated MassHealth regulations and state law by submitting false claims to MassHealth for payment.
• In September 2020, a Lowell-based home health company, Altranais Home Care, LLC, agreed to pay $3.1 million to resolve allegations that it had billed MassHealth for home health services that were not appropriately authorized by a physician.
• In September 2020, AG Healey announced criminal neglect charges against the former superintendent and former medical director of the Soldiers’ Home in Holyoke.
The Medicaid Fraud Division receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award. The remaining 25% is funded by the Commonwealth of Massachusetts, according to the AG’s office.
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