Statistical flags indicate unusual patterns — not proof of fraud or wrongdoing. Read our methodology

Wec Health, LLC

Foster Care Agency

Framingham, Massachusetts

NPI: 1639574635

Risk Tier

Elevated

Total Paid

$126.4M

$126,410,419

Total Claims

1.1M

Beneficiaries

57K

Avg Cost/Claim

$120.23

Active billing period: 84 months (2018-01 to 2024-12)

Statistical Fraud Flags (1)

Single-Code

Billing almost exclusively for 1-2 procedure codes despite high total volume.

Bills primarily for code T1028 (2 unique codes).

Advanced Detection Signals

CUSUM Change Point

Billing shifted 3.1x in 2021-08 — a statistically significant structural change in billing behavior was detected.

Suspicious Concentration

Herfindahl-Hirschman Index of 1 across 2 procedure codes — billing is highly concentrated in very few services.

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