On August the 9th, Massachusetts Attorney General, Maura Healey, announced that a Massachusetts Healthcare company had agreed to pay more than $750,000 for improperly billing hundreds of MassHealth members. Apria Healthcare, which provides home healthcare products to customers throughout the nation, will pay the fine for directly billing customers for services that would be covered by the state’s Medicaid program, MassHealth. The settlement will be used to provide refunds to hundreds of MassHealth members.
Under the terms of the agreement, Apria will pay $99,008 in restitution and $665,934 in penalties. In return, the allegations that the company billed members for services that would be covered by MassHealth will be resolved. Attorney General Healey made a statement about the settlement.
“MassHealth provides critical healthcare to low-income individuals, including people with disabilities, children and senior citizens, yet this company billed them for services that were already covered. Through our settlement with Apria, hundreds of members who paid bills they did not owe will get their money back.”
Apria has two locations in Massachusetts. They’re located in Wilmington and Springfield. The company provides consumers with access to medical services and devices. The Attorney General’s Medicaid Fraud Division launched an investigation after a recommendation by MassHealth’s Provider Compliance Unit and the UMass Medical School Enhanced Coordination of Benefits Division. The latter had received complaints from consumers claiming that Apria was attempting to collect money for their services, despite said services being covered by MassHealth.
The investigation concluded that Apria had inappropriate billed more than one-thousand members for hundreds of thousands of dollars in services from December 2011 to April 2017. The actions violated MassHealth regulations and consumer protection laws. The Attorney General’s Office believes more than 500 MassHealth members paid their bills and they’ll now receive restitution.
Simultaneously, Apria has been ordered to cooperate with the Attorney General’s Office to help repair the credit scores of consumers that may have been impacted by the behavior. The firm will also be required to implement a compliance monitoring program to prevent similar action in the future. Assistant Attorney General Nita Klunder and Investigator Robert Ames handled the matter.