BOSTON, Mass. (Office of the Attorney General)-Attorney General Maura Healey announced that her office’s Medicaid Fraud Division recovered more than $55 million in calendar year 2021.
The AG’s Medicaid Fraud Division investigates and prosecutes providers who defraud the state’s Medicaid program, MassHealth. The Division is also responsible for reviewing complaints of abuse, neglect, mistreatment, and financial exploitation of patients in long-term care facilities and MassHealth members in any health care settings.
In 2021, the Division secured 22 civil settlements with various entities, including home health agencies, substance abuse treatment facilities, adult day health centers, adult foster care providers, skilled nursing facilities, and dental practices. The overwhelming majority of the Division’s recoveries were returned to MassHealth, but funds were also returned to the Department of Public Health’s Long-Term Care Facility Quality Improvement Fund; patients who had paid out-of-pocket for services that should have been covered by MassHealth; the federal Medicare program; and whistleblowers who brought lawsuits against providers alleging fraud.
“I’m proud of the vital work our Medicaid Fraud Division does to protect our most vulnerable residents, safeguard taxpayer dollars, and uphold the integrity of the MassHealth program,” said AG Healey. “Addressing fraud and misconduct in the health care sector is a top priority for my office, and we will continue this important work in 2022.”