Woman Behind Quincy Medicare Fraud Scheme Gets Jail Sentence

QUINCY, MA — A woman from Quincy who has pleaded guilty to Medicare fraud through her behavioral health clinic in the past, was sentenced to three to four years in state prison on top of a previous sentence. Attorney General Maura Healey claims she billed public and private insurances for services that were never given to patients.

Nicole Kasimatis, 48, owner of Fortitude Counseling, pleaded guilty Thursday in Norfolk Superior Court to charges of larceny (3 counts), filing a false health care claim (2 counts), and Medicaid false claims (2 counts.)

Following Thursday's change of plea, Kasmatis' probation from previous cases was revoked, and she was also sentenced to two to three years in state prison to run concurrently with her three-to-four-year prison sentence

Attorney General Maura Healey's Medicaid Fraud Division began an investigation into Kasimatis' billing practices in 2019, following a referral from the Insurance Fraud Bureau and the Norfolk District Attorney's Office.

In November 2021, Kasimatis was indicted and arraigned on charges of Medicaid false claims, larceny over $1,200, and filing a false health care claim - three years after her last indictment.

Those charges claim Kasimatis billed for mental health services she did not perform, either because she was incarcerated or out of the country, Healey's office said. She also billed for services not rendered by licensed or supervised Fortitude employees; and billed for services under the name and number of providers who no longer worked for Fortitude and who did not provide the services, Healey added.

The amount of money Kasimatis gathered from MassHealth as a result of these schemes is more than $480,000. She also received $4,800 from private insurance for services not rendered.

In January 2022, Kasimatis was arraigned on additional charges in connection with her billing scheme, by filing false Medicare claims for services not rendered and getting paid approximately $44,000.

Read more: Quincy Woman Charged With Medicare Fraud For Fourth Time

Kasimatis used funds she received through Medicaid and Medicare for her own personal use, including vacations to Disney, Red Sox games, weight loss services, and even to post bail for her prior charges, Healey added.

"This provider took advantage of her access to patients for personal financial gain, undermining the integrity of federal health care programs and wasting valuable taxpayer dollars," said Phillip Coyne, Special Agent in Charge with the U.S. Department of Health and Human Services, Office of Inspector General.

In 2015 and 2018, Kasimatis was indicted by the Norfolk County DA's Office for public assistance fraud and larceny, she pleaded guilty in Norfolk Superior Court in November 2020.

Kasimatis is also forever banned from providing services that could be reimbursed by public or private health insurance.

"This defendant had a responsibility to provide patients with critical behavioral health services, but she instead chose to defraud the system for her own personal gain," said AG Healey. "We are grateful to our partners in this case for working with us to hold this defendant accountable for her crimes and to protect our state resources from these schemes."