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Friday, February 28, 2020

Mass. False Claims Act action results in $850K to Medicaid programs

By Mark Payne | Dec 4, 2014

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BOSTON (Legal Newsline) - A medical equipment company will pay back approximately $230,000 to Massachusetts' Medicaid program over allegations that it filed false claims, Attorney General Martha Coakley announced on Tuesday.

Regional Home Care Inc., which operates under the name North Atlantic Medical Services, allegedly submitted Medicaid claims to MassHealth for respiratory therapy services rendered by unlicensed employees between September 2010 and January 2013. The employees were sent to patients' homes to set up sleep apnea masks and oxygen therapy equipment.

Massachusetts Department of Public Health regulations require employees to have professional licenses for respiratory therapy services, which require having an associate's degree in respiratory therapy and passing a national board exam.

The state further alleges that Regional Home Care continued to employ unlicensed workers to provide respiratory therapy services even after the health department told the company it was illegal to do so. 

“Companies responsible for in-home respiratory services must comply with licensure requirements to maintain patient safety,” Coakley said. “Our office is committed to working with our partners in federal and state law enforcement to ensure these medical equipment suppliers adhere to regulations in Massachusetts.”

In addition to reimbursing the state Medicaid program, the company must repay more than $620,000 to the federal Medicaid program.

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