Home Health Owner Charged With Defrauding Mass. Health Out Of $2.7 Million

STURBRIDGE, MA—The owner of a Massachusetts home health agency was arrested in connection with allegedly stealing approximately $2.7 million from the state’s Medicaid program (MassHealth) by routinely overbilling and falsely billing for services that were not authorized, Attorney General Maura Healey announced Wednesday.

Hellen Kiago, 47, of Sturbridge, was arrested on Wednesday morning by Massachusetts State Police. A Statewide County Grand Jury returned indictments against Kiago and her company, Lifestream Healthcare Alliance, Sept. 28.

Kiago was indicted on charges of Medicaid False Claims (five counts) and Larceny over $250 by False Pretenses (one count). Lifestream was indicted on the same charges.

Kiago and Lifestream were arraigned Wednesday in Worcester Superior Court, where they pleaded not guilty, the announcement said. Bail was set at $100,000 for Kiago, with the conditions that she surrender her passport and call the Probation Department weekly. The defendants are due back in Worcester Superior Court Dec. 6 for a pre-trial conference.

Lifestream is a home health agency with offices located in Worcester and Dracut and Kiago is the sole owner. The agency was established to provide home health services to individuals covered by the MassHealth program, including skilled nursing and home health aide visits.

The AG’s Office began an investigation after receiving complaints from several former employees alleging misconduct and fraudulent billing practices.

It is alleged by investigators that since at least July 2015 , Kiago, through Lifestream, billed MassHealth for allegedly providing patients with home health services that were not authorized by a physician, billed far in excess of the hours a physician had authorized or retained overpayments received from MassHealth. The indictments also allege that the defendants billed MassHealth for services that were not authorized by physicians and that Kiago instructed an employee to forge physician signatures on certain patient plans of care that were unsigned, said the AG in the release.

In numerous instances, the AG's announcement also noted, Lifestream aides submitted more hours on their time-sheets for services provided than what was listed in the corresponding plan of care. Kiago allegedly told employees to give patients with hours beyond those deemed medically necessary by the clinician in the field.

Lastly, the AG's office said that Kiago in 2016 hired an additional staff to handle an internal audit that was falsified in the documents so paperwork would be correct for an upcoming accreditation audit.

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