Two women, with Kenyan roots, are in trouble with the American authorities for allegedly stealing from the Boston state health sector up to Kshs 12 billions.
The duo, Winnie Waruru, 52, and Faith Newton, 42, are accused of conspiring to commit healthcare fraud and “billing for healthcare services that they never provided” as well as making false statements.
The accused person allegedly ran a homecare service company that received payments from the health cover programmes for services that they did not offer, were unneccessary and which were not recommended by a doctor.
The women, who operated as nurses, are said to have been living a lavish life. They drive high end cars, have five properties in the country as well as operate 40 bank accounts after successfully stealing from the healthcare cover programmes intended for the low class citizens in a period of five years.
They swindled the billions from Masshealth and Medicare programmes between 2013 and 2017 through their company Arbor Homecare Services LLC by claiming refunds and ‘filling false statements,” before closing it down in 2017. The company was registered under Njoroge Muiruri who is also a registered nurse.
Masshealth programme offers payments for personal care attendants, medical equipment, and specific prescription.
Apparently, Winnie and Faith bribed patients so that they could retain them under Arbor homecare and also obtain referrals which in some cases had no need of medical attention.
They would also forge nurse visits and fake ’employment’ relationships with mass health patients’ family members who posed as caregivers. They would then claim for refunds for the payment of the ‘fake’ caregivers.
“By entering into “sham” employment relationships with patients’ family members it was easy for Arbor to purport to provide home health aide services that were not medically necessary and routinely billed for fictitious visits that did not occur,” the prosecution said.
In the scam, the two women mostly targeted people with low-income, those with mental challenges and persons with disabilities.
Last week, Winnie pleaded guilty to the charges against her and her judgment would be issued on January 12, 2023. On the other hand, Faith’s case is still ongoing.