Nicole Kasimatis used nearly $500,000 she defrauded from MassHealth for posting bail, Disney trips and Red Sox games, officials say [masslive.com]

A Quincy woman was sentenced to three to four years in prison Thursday for defrauding MassHealth and other insurance providers and using the funds to post bail for previous criminal charges, trips to Disney and internationally and Red Sox games.

Nicole Kasimatis, 48, pleaded guilty to three counts of larceny over $1,200, two counts of filing a false health care claim and two counts of Medicaid false claims in Norfolk Superior Court Thursday, according to Attorney General Maura Healey’s office.

Following her guilty plea, Judge Peter Krupp ordered Kasimatis’s three- to four-year sentence followed by three years of probation.

The conditions of her probation include that she pay restitution- the amount of which will be determined at a later date, not work for a MassHealth provider, not bill MassHealth for services, stay in the state, forfeit any passports and stay away from and have no contact with named witnesses, according to the AG’s office.

The AG’s Medicaid Fraud Division opened an investigation into Kasmatis in 2019 at the recommendation of the Insurance Fraud Bureau and the Norfolk District Attorney’s office.

“This is a result of a joint effort between the AG’s Office and the Insurance Fraud Bureau of Massachusetts,” Anthony M. DiPaolo, Executive Director of the Insurance Fraud Bureau said in a press statement. “Today’s sentence shows that this activity is not tolerated in Massachusetts, and we will aggressively investigate this type of fraud.”

Kasmatis was arrested and arraigned in November 2021 on charges related to billing MassHealth for nearly $500,000 worth of substance use disorder and/or mental health services she did not perform because she was either in jail or out of the country and billing private insurance companies for at least another $4,800, the AG’s office said.

Investigators found she also billed for services not performed by licensed Fortitude employees and for services under the name and number of providers who no longer worked for the Quincy-based mental health treatment and recovery center, according to the AG’s office.

Kasimatis was arraigned on additional charges in January connected with filing false Medicaid claims totaling $44,000.

Kasimatis used the money she amassed from her schemes to pay for international and Disney trips, Red Sox games, baseball camps for her children, weight loss services and to post bail for previous criminal charges.

In November 2020, she pleaded guilty to public assistance fraud and larceny, according to the DA’s office.

Her guilty plea on Thursday resulted in her probation from the previous cases being revoked and a two- to three-year sentence to state prison to be served at the same time as her three- to four-year sentence.

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

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