Dive Brief:
- Molina Healthcare and its previously owned subsidiary, Pathways of Massachusetts, agreed to pay over $4.6 million to settle claims that it violated the False Claims Act by submitting reimbursements to MassHealth, the state’s Medicaid Program, for services provided by inadequately licensed and unsupervised staff, the Department of Justice announced Tuesday.
- The settlement comes after four former Pathways employees brought a suit against the company and an investigation was launched into the behavioral health clinics by the attorney general’s Medicaid fraud division.
- “This company routinely allowed unlicensed and unsupervised mental health professionals to provide care to patients, all while billing MassHealth for it,” Massachusetts Attorney General Maura Healey said in a statement. “MassHealth patients deserve to receive treatment from qualified individuals, and my office will continue to hold providers accountable for violating these fundamental MassHealth requirements.”
Dive Insight:
The Long Beach, California-based managed care company is the latest to settle a False Claim Act violation with the DOJ, which settled over $5.6 billion in false claims and fraud under the act for the fiscal year ending September 30, 2021.
The attorney general’s office and investigation found that Pathways “failed to meet the regulatory requirements for frequency and adequacy of supervision, the qualifications of its supervisors, and that Pathways billed for psychotherapy...
Read Full Story:
https://www.healthcaredive.com/news/molina-healthcare-agrees-pay-over-46-mill...
