| PHOTO: | Hellen Kiago is arraigned in October 2017 in Worcester Superior court on Medicaid fraud charged. PIC BY COURTESY,Telegram & Gazette Staff/Christine Peterson. |
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By:
Gary V. Murray
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| Posted:
Jul,14-2019 00:02:00
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WORCESTER__A former Worcester teacherconvicted of bilking the state's Medicaid programout of what prosecutors alleged was $2.5 million was ordered to serve 18 months in jail Friday and fined a total of $65,000.
Hellen Kiago, 48, of Sturbridge was found guilty May 14 in Worcester Superior Court of charges related toallegations she fraudulently billed MassHealth through Lifestream Healthcare Alliance,a home health agency she owned with offices in Worcester and Dracut. Prosecutors from the office of Attorney General Maura Healey charged that MassHealth was billed for services not authorized by doctors and that Lifestream employees were directed to assist patients for longer time periods than were necessary.
They further alleged that Ms. Kiago directed employees to falsify documents to conceal wrongdoing, including forging physician signatures during a MassHealth audit and creating "false corrective orders."
Ms. Kiago and Lifestream were each found guilty after a 10-day trial of four counts of filing false Medicaid claims and one count of larceny of more than $250 by false pretenses.
Judge Robert B. Gordon sentenced Ms. Kiago Friday to 2.5 years in the House of Correction, with 18 months to be served. The balance of the jail sentence was suspended for 1 year with administrative probation. Ms. Kiago was given credit for 10 days she spent in confinement after being found guilty.
Ms. Kiago was also fined a total of $65,000, as was Lifestream Healthcare Alliance LLC.
The prosecution had recommended that Ms. Kiago be sentenced to 2 years imprisonment and ordered to pay restitution of $2.5 million, according to Assistant Attorney General Nita K. Klunder.
Ms. Kiago's lawyer, Sylvester J. Boumil Jr., asked the judge to sentence her to time served.
In his sentencing memorandum, Judge Gordon said the evidence at trial demonstrated that the defendants "engaged in deliberate wrongdoing over a protracted period of time" and that their financial crimes "victimized a health care agency whose limited resources are meant to serve the Commonwealth's most vulnerable citizens."
"This was not a case of simple negligence or managerial incompetence, as the Defendants now argue," the judge wrote.
"Moderating the severity of the Court's sentence is the fact that the Defendants present with no criminal record" and had, for many years, "employed a diverse workforce to furnish home healthcare services to a poor and underserved patient population," Judge Gordon said in his memorandum.
"Likewise, although the Defendants submitted bills to MassHealth for services that had not been physician-authorized as 'medically necessary' in the time and manner required by the Medicaid program's regulations, there is no evidence that member patients ever failed to receive the skilled nursing and home health services that Lifestream Healthcare Alliance invoiced to this agency.
"Nurses and home health aides provided care-giving to patients and were paid for their work. Billing regulations were violated, to be sure, and those violations were then concealed through culpable behavior that included the diversion of money to Kenyan bank accounts. But the Defendants were not profiteering out of greed at the expense of the indigent or the government, as the Attorney General suggests," Judge Gordon wrote.
The judge said he had also taken into consideration that Ms. Kiago had, "present circumstances notwithstanding," led "a commendable life." He noted that she held multiple advanced educational degrees, served for many years as a mathematics teacher in the Worcester public schools and had "contributed to her civic and religious communities in myriad ways."
Her lawyers had previously said that Ms. Kiago came to the U.S. from Kenya on a scholarship in 1998.
Judge Gordon noted in his memorandum that he had not ordered restitution as a condition of Ms. Kiago's probation.
"The matter of what constitutes truly fair restitution in this unusual case is complex; and the Court is not satisfied that justice can be derived from the kind of simple arithmetic exercise urged upon it by the Commonwealth."
"In all events, recapturing large sums of money from a business that is presently in mothballs, and from a woman who likely faces deportation following her release from confinement, will prove challenging," the judge wrote.
He suggested the attorney general's office pursue restitution civilly.
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