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February 17, 2017

Posted  February 17, 2017

A Wellesley-based dental provider and its billing agent have agreed to pay $1.5 million to Massachusetts’ Medicaid program (MassHealth) to resolve allegations of improper billing for visits to MassHealth members living in nursing homes. The settlement resolves allegations that dental provider Alec H. Jaret, DMD, PC d/b/a HealthDrive Dental Group and its billing agent, HealthDrive Corporation, overbilled MassHealth for nursing home visits. The AG’s Office filed a complaint against the defendants in March 2014 alleging that between July 2010 and September 2013, HealthDrive, on behalf of HealthDrive Dental Group, overbilled MassHealth for nursing home visits by charging a separate “house call” fee for multiple patients treated at the same facility on the same day. An investigation by the AG’s Office revealed that HealthDrive was paid for more than 34,700 excessive claims on a per-patient per-day basis, contrary to MassHealth’s regulations on dental house calls established in 2010. The parties have reached a civil settlement agreement pursuant to which HealthDrive and HealthDrive Dental Group will pay MassHealth $1,500,756 to resolve all claims. MA

Tagged in: FCA State, Medicaid, Medical Billing Fraud,