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Case in Massachusetts sounds alarm after woman accused of fraudulently billing MassHealth for $500,000
Congressional leaders exploring fraud and waste in the Medicaid program that is funded with state and federal dollars want information and documents from officials in 10 states, including Massachusetts.
U.S. Reps. Brett Guthrie of Kentucky, John Joyce of Pennsylvania and Morgan Griffith of Virginia said letters issued this month to state health and human services officials are part of their ongoing investigation into waste, fraud, and abuse within Medicaid programs based on law enforcement efforts in several states. Guthrie chairs the House Committee on Energy and Commerce and the other congressmen chair subcommittees of that panel.
“It’s no secret that Medicaid fraud schemes have possibly cost the program billions of dollars annually across the country. These schemes contribute greatly to rising health care costs and strain our health care system, all at the expense of Medicaid beneficiaries and taxpayers,” Guthrie’s office said March 5.
His office cited a case in Massachusetts in which a woman pleaded guilty to fraudulently billing MassHealth for $500,000 in personal care attendant, home health and adult foster care services after enrolling individuals in services without their knowledge and billing Medicaid as their caretaker despite not providing the services.
In addition to Massachusetts, the congressmen also sent letters to officials in California, Colorado, Maine, Nebraska, Oregon, Pennsylvania, Vermont and Washington, with Guthrie’s office stating that “each of these states displayed concerning cases of Medicaid fraud over the last several years.”
In their March 5 letter to Gov. Maura Healey and Health and Human Services Secretary Kiame Mahaniah, the chairmen asked for answers to 10 questions to be returned to the committee by March 17.
The chairmen state in their letter that Massachusetts “broadly defines Medicaid eligibility and administers several Medicaid programs that are considered high risk” for fraud, waste and abuse, including non-emergency medical transportation, the Personal Care Attendant program, home health and clinical laboratory services.
