Wec Health, LLC
Single-Code
Billing almost exclusively for 1-2 procedure codes despite high total volume.
Bills primarily for code T1028 (2 unique codes).
Statistical flags are not proof of wrongdoing. Some entities (government agencies, home care programs) may legitimately bill at high rates. Hospitals, government entities, and large care organizations may legitimately bill at higher rates due to patient acuity, overhead costs, or specialized services. Read our methodology.
Red Flags Explained
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Each flag represents a statistical test that identified unusual billing patterns. Here's what each flag on this provider means in plain English:
Single-Code
Single-Code Billing means this provider bills almost exclusively for one or two procedure codes despite high total volume. Legitimate specialists may focus on specific codes, but extreme concentration can indicate a scheme billing repeatedly for the same service.
These flags are statistical indicators only. Many flagged providers have legitimate explanations for their billing patterns. Learn more about our methodology.
Advanced Detection Signals
Additional statistical tests from advanced fraud detection methods
These signals use advanced statistical methods including digit distribution analysis, change-point detection, and market concentration metrics. Learn more.
Risk Assessment
Extreme procedure concentration — 100% of all billing flows through just 2 codes (S5140, T1028).
Bills $257.50 per claim for T1028 (Assessment of home, physical & family environments) — 3.2× the national median of $81.30.
This is a statistical summary, not an accusation. See our methodology.
Compared to Foster Care Agency Peers
Total spending distribution among 10 providers in this specialty
This provider's total spending of $126.4M is at the 75th percentile among 10 Foster Care Agency providers.
Extreme procedure concentration — 100% of $126.4M billed through just 2 codes
Total Paid
$126.4M
$126,410,419
Total Claims
1.1M
Beneficiaries
57K
18.3 claims/patient
Avg Cost/Claim
$120
#929 of 618K providers by total spending(top 0.2%)
🔍 Analysis
Provider Overview
Wec Health, LLC is a Foster Care Agency provider based in Framingham, MA. From the 2018–2024 period, this provider received $126.4M in Medicaid payments across 1.1M claims.
Why This Matters
This provider received $126.4M in taxpayer-funded Medicaid payments — enough to fund healthcare for approximately 15,801 Medicaid beneficiaries for a full year at average per-enrollee costs.
Monthly Spending Trend
Yearly Spending
Procedure Breakdown
Cost per claim compared to national benchmarks
This provider bills for 2 distinct procedure codes. The top code (S5140 (Foster care, adult; per diem)) accounts for 100% of total spending.
$126.0M
1.0M claims
$120.02
$252.32
Foster care, adult; per diem
$126.0M
1.0M claims · 99.7%
$404K
2K claims
$257.50
$81.30
Assessment of home, physical & family environments
$404K
2K claims · 0.3%
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