Worcester News

Worcester woman, firm admit to $1.6M MassHealth fraud

  • Posted by Worcester News 12 hours ago - Filed in News - #Worcester  #crime  #Fraud  #Mass. Attorney General  #MassHealth  - 2,331 views


    LEONARDO DASILVA, CC BY 3.0, via Wikimedia Commons

    WORCESTER — A Worcester-based home health care company and its administrator have pleaded guilty to charges in a scheme that defrauded MassHealth of more than $1.6 million, the Massachusetts Attorney General’s Office announced Thursday.

    Union Home Health Care Services and its administrator, Bernice Codjia, 41, pleaded guilty in Worcester Superior Court to larceny over $1,200 and Medicaid false claims. Prosecutors said Codjia used fraudulent nursing assessments and forms to enroll MassHealth members and bill for group adult foster care services that were never authorized or provided.

    Codjia was sentenced to a year in the House of Correction, suspended for 3 years, and barred from offering services to MassHealth members or participating in billing during that time. Union, which is no longer in business, was ordered to pay nearly $300,000 in restitution and is prohibited from providing services or billing MassHealth.

    Authorities said the company billed for services not rendered, including periods when members were in inpatient facilities. MassHealth’s group adult foster care program provides assistance with daily activities for elderly and disabled members so they can live independently.

    Trials for other co-defendants in the case are pending. The A.G.’s office said the case is part of a broader effort to combat fraud in home-based services programs.

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