Medicaid provider accused of fraud

Allegedly billed for dead patients

October 01, 2011|By Patricia Wen and Brian Ballou, Globe Staff
  • State Attorney General Martha Coakley announced Medicaid fraud indictments yesterday.
State Attorney General Martha Coakley announced Medicaid fraud indictments… (David L. Ryan/Globe Staff )

FRAMINGHAM - A nonprofit agency that promoted itself as a compassionate organization devoted to helping disabled, indigent adults stay in their homes was accused by state prosecutors yesterday of running a cynical scam, billing the state for about 20 patients who had been dead for some time.

Prosecutors also said Adlife Healthcare - run by Sharon Richardson at locations in Framingham, Dorchester, Hyannis, and West Springfield - charged Medicaid for home health aid services rendered to more than 100 infirm patients even though its staff had not done the work.

These billing practices, as well as three other unrelated Medicaid fraud schemes in the state, siphoned a total of $10 million from MassHealth, the state’s Medicaid program providing health insurance for the poor, Attorney General Martha Coakley said yesterday in announcing the grand jury’s indictment of 10 individuals.

Her office released names of nine of the indicted defendants but declined to name the 10th, saying it had been sealed by the courts. No reason was given.

A lawyer for Adlife’s owner defended her as a hard-working victim of paperwork misunderstandings and outsized charges. But Coakley described the operation, and the three others, as theft of taxpayer dollars that hurts everyone in the state.

“It means your health care costs go up; it’s like shoplifting in stores,’’ she said at a news conference outside her Boston office.

Others indicted yesterday included Dr. Punyamurtula Kishore, 61, a Brookline drug-addiction specialist who had been arrested nine days ago on an initial charge, though the full scope of the grand jury case against him was not made clear until yesterday. His arrest was put on an accelerated schedule by prosecutors because they feared he was about to flee the country, perhaps to his native India.

Yesterday, Kishore was charged with building a urine-screening business by bribing at least four operators of sober houses, facilities for recovering substance abusers, to send referrals his way. The intricate kickback scheme involving his company, Preventive Medicine Associates, produced $3.8 million in fraudulent Medicaid billing by using bribery as a means to get business, the state alleges.

His lawyer, who had defended him at his Sept. 21 hearing as a “well-regarded member of the community,’’ did not return phone calls yesterday. Kishore is free on personal recognizance, under the condition that he wear a GPS tracking device and turn over his passport.

Indicted for allegedly receiving kickbacks from Kishore were Carl Smith, 65, of Dorchester, manager of New Horizon House; John Coughlin, 31, of Carver, president of Gianna’s House facilities in Wareham, New Bedford, and Sandwich; and Thomas Leonard, 56, of Malden, manager of Marshall House in Malden.

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