The owner of a transportation company has pleaded guilty to fraudulently billing millions in false claims to the state’s Medicaid Program (MassHealth), Attorney General Maura Healey announced today.
Michael Davini, age 59, of Rindge, N.H., pleaded guilty in Worcester Superior Court on October 24 to charges of Larceny Over $250 (2 counts), Medicaid False Claims (2 counts), and Kickbacks (1 count). His company, Rite Way LLC, also pleaded guilty to charges of Medicaid False Claims (2 counts). Today, Judge William J. Ritter sentenced Davini to serve one year in the House of Correction followed by a five-year probationary term, which includes a two and a half-year suspended sentence, and restitution totaling approximately $4.2 million. During his probation, Davini is prohibited from involvement in federal or state healthcare programs.
The AG’s Office began an investigation after the matter was referred by MassHealth. Rite Way provided transportation services throughout the state that were covered by MassHealth.
Between April 2011 and September 2015, Davini fraudulently and repeatedly billed MassHealth for transportation services that were never provided, including claims for individuals who were hospitalized in inpatient settings, no longer used the company’s services, or were deceased on the claimed dates of service. Investigators also found that Rite Way provided non-emergency wheelchair van transportation provided to ambulatory individuals and paid cash kickbacks to MassHealth members to recruit others to use its transportation services. Davini was indicted with others in September 2016 in connection with these false claims.
MassHealth provides non-emergency transportation services to aid its members in traveling to obtain covered medical services when public or personal transportation is not available or not suitable due to the member’s physical condition and circumstances. Pursuant to its regulations, MassHealth only pays transportation providers for non-emergency wheelchair van services provided to members who: (1) use wheelchairs; (2) need to be carried up or down stairs or require the assistance of two persons; or (3) have severe mobility handicaps that prevent them from using public transportation, dial-a-ride, or taxi transportation.
This matter was handled by AG Healey’s Medicaid Fraud Division, led by Managing Attorney Ian Marinoff, Assistant Attorneys General Ali Russo and Christina Chan, Senior Trial Counsel Elisha Willis, Investigations Supervisor Dean Bates, Senior Health Care Investigators Aleksandra Andriyevskaya, Steven Pfister, and Robert Ames, and Investigator Matthew Baldwin. MassHealth and the State Auditor’s Office provided significant cooperation in this investigation.
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Photo courtesy of: Mass.gov
Originally Published On: Mass.gov
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