Woman charged with Medicaid fraud 4 times pleads guilty – InsuranceNewsNet

QUINCY – The owner of a Quincywas sentenced to three to four years in state prison after pleading guilty to defrauding public and private insurance companies, including the state’s Medicaid program.

Nicole Kasimatis48 years old, from Quincyowner of Fortitude Advice and Recovery Center in Quincypleaded guilty to Norfolk Superior Court with three flight leaders on $1,200two counts of filing a false health care claim and two counts of filing false Medicaid claims.

Judge Peter Krupp ordered her to serve 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. She must also stay in Massachusetts and confiscate any passports, and stay away and have no contact with the named witnesses. The amount of the refund has not been determined.

Attorney General At Maura Healey’s Medicaid’s Fraud Division opened an investigation into Kasimatis’ billing practices in 2019, following a referral from the Insurance Fraud Bureau and the Norfolk County district attorney’s office.

In November 2021Kasimatis was arrested and charged with defrauding MassHealth of nearly $500,000 by billing for substance use disorders and other mental health services that she did not render. Prosecutors say she also billed for services not performed by authorized or supervised Fortitude employees and for services under the name and number of vendors who no longer worked for her.

In January 2022Kasimatis was indicted for additional costs for filing false health insurance claims for services not rendered and being paid for approximately $44,000. Kasimatis was also indicted in 2015 and 2018 in two other cases for public assistance fraud, larceny, falsifying documents and issuing a false warrant.

Kasimatis used the money from his schemes for his personal use, including paying for international travel, disney trips, Red Sox games, baseball camps for his children, weight loss services and even posting bail for his previous criminal charges, Healey’s office said.

“This defendant had a responsibility to provide patients with essential behavioral health services, but instead chose to defraud the system for her own personal gain,” Healey said in a statement. “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’s resources from these schemes.”

Following her guilty plea, Kasmatis’ probation in the previous cases was revoked and she was sentenced to two to three years in state prison to run concurrently with her three to four year prison sentence.

Reach Mary Whitfill at [email protected].

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