Pathways of Massachusetts Had Insufficient Clinical Supervision and Documentation Practices, Causing Millions of Dollars in False Claims to MassHealth
BOSTON — Pathways of Massachusetts (Pathways), a former Massachusetts outpatient behavioral health provider, and Molina Healthcare, Inc. (Molina), its former corporate parent, will pay $4.6 million to resolve false claims allegations by the Attorney General’s Office, as well as additional allegations made by whistleblowers, Attorney General Maura Healey and United States Attorney Rachael Rollins announced today.
According to the AG’s Office, Pathways caused fraudulent claims to be submitted to the state’s Medicaid Program, known as MassHealth, for behavioral health care services provided to patients by unlicensed and improperly supervised staff members. An investigation by the AG’s Office 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 services rendered by unlicensed individuals who were not supervised by appropriately licensed professionals.
“This company routinely allowed unlicensed and unsupervised mental health professionals to provide care to patients, all while billing MassHealth for it,” said AG Healey. “MassHealth patients deserve to receive treatment from qualified individuals, and my office will continue to hold providers accountable for violating these fundamental MassHealth...
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