New England Home Care Inc.
Home Health
Rocky Hill, Connecticut
NPI: 1255333597
Risk Tier
High
Total Paid
$400.1M
$400,057,183
Total Claims
6.8M
Beneficiaries
527K
Avg Cost/Claim
$59.13
Active billing period: 83 months (2018-01 to 2024-11)
Statistical Fraud Flags (2)
Cost Outlier
Billing over 3× the national median for specific procedure codes.
Bills $58.49 per claim for T1502 (Administration of oral, intramuscular, or subcutaneous medication), which is 7.4× the national median of $7.86.
Rate Outlier
Billing above the 90th percentile across multiple procedure codes simultaneously.
Billing above the 90th percentile for 2 procedure codes: S5185 at 3.1× median, 1448P at 1.6× median.
Advanced Detection Signals
Billing Velocity
3705.3 claims per working day — may exceed physically possible volume for a single provider.
Disclaimer: Statistical flags indicate unusual billing patterns — they are not proof of fraud or wrongdoing. Some entities (government agencies, home care programs, hospitals) may legitimately bill at higher rates due to patient acuity, overhead costs, or specialized services. This report is generated from public HHS data and statistical analysis only. No clinical or investigative review has been performed.
Generated by OpenMedicaid | openmedicaid.org | Data: HHS 2018-2024