Lawsuit against HealthDrive seeks at least $1.1M

By Bryan Cohen | Mar 12, 2014

BOSTON (Legal Newsline) - Massachusetts Attorney General Martha Coakley announced a lawsuit on Tuesday against a Wellesley-based dental provider for allegedly overbilling the state's Medicaid program for more than $1.1 million.

Since July 2010, HealthDrive Corporation allegedly overbilled for nursing home visits by charging a separate house call fee for multiple patients treated at the same facility on the same day. Providers are allowed to charge for treating multiple patients on the same day, but MassHealth limits the separate house call charge to one per facility per day, no matter how many patients receive dental care.

HealthDrive allegedly continued the improper billing practice after MassHealth officials directly told the corporation's chief executive officer that it was illegal.

"We allege this dental provider collected more than $1 million in overpayments from MassHealth despite having knowledge that its billing practices violated state regulations," Coakley said. "Providers who take advantage of this MassHealth program weaken the commonwealth's ability to maintain it."

Coakley's lawsuit alleges that HealthDrive received improper payment for more than 34,000 claims on a per-patient, per-day basis.

The lawsuit seeks restitution, civil penalties and other compensation.

In a similar matter in February, Coakley reached a settlement with an Easton-based dentist who allegedly received overpayments from MassHealth for dental house calls. Donald Prohovich agreed to pay $400,000 to resolve the allegations.

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