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. In addition, Kasimatis obtained at least another $4,800 from private insurance companies for services not rendered. In November 2021, Kasimatis was arrested and arraigned for defrauding MassHealth of nearly $500,000 by billing for substance use disorder and/or mental health services she did not perform either because she was incarcerated or out of the country billing for services not rendered by licensed or supervised Fortitude employees and billing for services under the name and number of providers who no longer worked for Fortitude and who did not provide the services. “HHS-OIG will continue to work tirelessly with our law enforcement partners to hold accountable perpetrators of health care fraud.” Department of Health and Human Services, Office of Inspector General (HHS-OIG). “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. “Today’s sentence shows that this activity is not tolerated in Massachusetts, and we will aggressively investigate this type of fraud.” DiPaolo, Executive Director of the Insurance Fraud Bureau. “This is a result of a joint effort between the AG’s Office and the Insurance Fraud Bureau of Massachusetts,” said Anthony M.
“This is an example of the importance of good working relationships between law enforcement agencies.” “I referred the Medicaid fraud portion of this investigation to Attorney General Healey with confidence that the specialized prosecutors in her office could bring that matter to a just conclusion,” said Norfolk County District Attorney Michael Morrissey. “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.”ĪG Healey’s Medicaid Fraud Division began an investigation into Kasimatis ’ billing practices in 2019, following a referral from the Insurance Fraud Bureau (IFB) and the Norfolk District Attorney’s Office. “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.
The restitution amount will be determined at a later date. Following the plea, Judge Peter Krupp ordered her to three to four years in state prison followed by three years of probation with the conditions that she pay restitution, not work for a MassHealth provider and not bill MassHealth for services, remain in Massachusetts and forfeit any passports, and stay away from and have no contact with named witnesses.
Nicole Kasimatis, age 48, pleaded guilty yesterday in Norfolk Superior Court to the charges of Larceny over $1200 (3 counts), Filing a False Health Care Claim (2 counts), and Medicaid False Claims (2 counts). Administration and Finance Accounting and Auditing Chapter 70 Program Chapter 74 Nonresident Tuition Charter Finance and Enrollment DESE Budget Federal Grant Programs Food and Nutrition Grants/Funding Opportunities Inter-District School Choice Regional Districts School Buildings School Finance Regulations Special Ed.BOSTON - A Quincy woman who owned a behavioral health clinic has pleaded guilty and been sentenced to serve three to four years in state prison in connection with a widespread fraudulent scheme to bill the state’s Medicaid program (MassHealth) and other private and government-funded insurance plans for behavioral health services that were never provided to patients or were improperly provided.
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