BOSTON (WHDH) - A Lawrence physician and members of his practice have been ordered to pay $515,000 to resolve allegations that they charged patients cash for a substance use disorder treatment covered by the state’s Medicaid program and billed for physician office visits performed by unlicensed medical assistants.
From December 2013 to December 2019, Dr. Miguel Verdaguer, office manager Christina Verdaguer, and Health Independent Providers, Inc., of Lawrence, charged MassHealth patients cash fees for covered urine drug screens related to Suboxone treatment in violation of state law, according to the settlement agreement with Attorney General Maura Healey’s office.
They also allegedly billed MassHealth for office visits that should have been performed by a physician but were instead conducted by medical assistants as if those visits had been done by Dr. Verdaguer.
“Putting up barriers to substance use disorder treatment makes it harder for patients to get this lifesaving care,” Healey said. “This alleged behavior puts people’s safety at risk, and we will continue to investigate and prosecute providers that take advantage of these vulnerable individuals.”
As part of the settlement agreement, $243,920 will be paid in restitution to current and former patients.
By law, MassHealth providers are required to accept payments from MassHealth as payment in full for covered substance use treatment services provided to MassHealth recipients.
In addition to the financial settlement, an assurance of discontinuance was filed in Suffolk Superior Court.
Health Independent Providers, Inc. will also implement a multi-year independent compliance program that will provide regular reports to the AG’s Office.
Members of the public who are aware of similar practices by other health care providers should call the AG’s Medicaid Fraud Division at (617) 963-2360 or file a complaint online.
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