BOSTON (Legal Newsline) — Massachusetts Attorney General Maura Healey announced Aug. 9 that Apria Healthcare LLC (Apria) will pay more than $750,000 to resolve allegations of directly billing people for services covered by the state’s Medicaid program (MassHealth).
Apria provides medical services and devices to MassHealth members. Healey’s Medicaid Fraud Division brought a case against the company after a reference from MassHealth’s provider compliance unit and the UMass Medical School's enhanced coordination of benefits division. According to allegations, the company inappropriately billed more than 1,000 members for hundreds of thousands of dollars for services that MassHealth covers. The alleged scheme took place between December 2011 and April 2017.
“MassHealth provides critical health care to low-income individuals, including people with disabilities, children and senior citizens, yet this company billed them for services that were already covered,” Healey said. “Through our settlement with Apria, hundreds of members who paid bills they did not owe will get their money back.”
Assistant attorney general Nita Klunder and investigator Robert Ames, both of Healey’s Medicaid Fraud Division, handled the case for the state. MassHealth provided assistance.