In Massachusetts, ten people and three companies are facing charges for conducting four fraudulent schemes that earned them millions from the taxpayer-funded MassHealth program. Attorney General Martha Coakley and her office said that health care fraud investigators have obtained 118 indictments, alleging four separate schemes to cheat the program that provides health insurance for qualifying middle and low-income people.
In the first scheme, AdLife Health Care LLC exec Sharon Richardson billed MassHealth $5.5 million for services never provided to patients. Richardson also billed for care allegedly provided to people who were actually deceased. Lisa Richardson-Miles and Kali Geddes were also charged in the scam.
The second scheme involves Dr. Punyamurtula Kishore of the Preventive Medical Association Inc. According to prosecutors, Kishore “engaged in a bribery and kickback scheme with eight sober houses to steer contacts for drug testing to [his] company,” reported Boston.com. Others charged in this scheme include: Carl Smith, manager of New Horizon; John Coughling, president of Gianna’s House Inc.; and Thomas Leonard, part owner and manager of Marshall Sober House.
In the third scheme, David M. Benson, a licensed clinical social worker,was charged with collecting over $150,000 for counseling that he never provided to six MassHealth clients. Benson allegedly billed for acute counseling care, which requires multiple weekly sessions, when only minimal, or no counseling was provided.
The fourth scheme involved Carolyn Wetterberg, owner of now-closed Jamaica Plain nursing home. Wetterberg allegedly overcharged MassHealth for services that were not needed or provided. Coakley said investigators found no sign that any of the patients suffered negative health consequences as a result of the schemes; however, she did name one victim of the alleged crimes – the taxpayers – “It means your health care costs go up,’’ Coakley said. “It’s like shoplifting in stores. Taxpayers are getting cheated.’’
The Fraud Dog says: “In order to control health care costs, we must put more audit controls in place to stop the tricky fraudster, who constantly tests the front end of billing practices with unique billing schemes.” “Are we really ready for universal health care, and are we prepared to stop the fraudster?” asks Linda Webb, star of the pilot reality series “Fraud Dog TV,” similar to America’s Most Wanted. “More front-end controls must be put into place. The fraudster found 4 different creative ways to bill health care, stealing millions of dollars.”
If you suspect someone of committing health care fraud, insurance fraud or any other type of fraud, contact Contego Services Group today at 1-855-WE-SWARM.