Largest Connecticut Not-For-Profit Health Agency To Pay ‘Record’ $11.9M in Medicaid Overbilling Settlement
Masonicare, Connecticut's largest not-for-profit care provider, has agreed to pay $11.9 million to settle charges that it improperly billed Medicaid, the Hartford Courant reports. The state had alleged that Masonicare had billed Medicaid for expenses that the program did not cover and for care provided to non-Medicaid patients. Most of the improper charges were reportedly billed through the Masonic Geriatric Healthcare Center, which includes a nursing home, acute care hospital and inpatient psychiatric facility. The state discovered the billing problems during a 1994 state Department of Social Services audit; a 1999 audit revealed that the "problems had only gotten worse." In the settlement -- the largest recovery of Medicaid funds in the state's history -- Masonicare acknowledged overcharging Medicaid since at least 1992, including billing for the purchase and renovation of buildings. State Attorney General Richard Blumenthal (D) said, "They literally threw in the kitchen sink in their claims for reimbursement." But Barry Spero, Masonicare president and CEO, said, "Quality of care was never questioned. It was never questioned that the dollars went to patient care. And there was never a question of fraud. What we had was some sloppiness in the accounting area." Over the next three years, Masonicare will pay back more than $10 million in money collected improperly and more than $1 million to cover the state's investigative costs. In addition, Masonicare has agreed to improve its accounting methods and hire a corporate compliance officer to review Medicaid billings (Kaufmann, Hartford Courant, 8/17). For further information on state health policy in Connecticut, visit State Health Facts Online.
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