BOSTON (Legal Newsline) - Massachusetts Attorney General Martha Coakley announced a settlement with a Revere physician on Friday who allegedly charged an improper $185 administrative fee in addition to MassHealth reimbursements for the treatment of opioid addiction.
Randall Bock allegedly took an improper administrative fee of $185 from MassHealth members in addition to receiving a reimbursement from MassHealth for opioid addiction treatment with the drugs Subutex and Suboxone. The practice of charging patients cash in addition to MassHealth reimbursement for Suboxone treatment is illegal. Bock agreed to pay more than $53,000 in restitution under the terms of the agreement.
"Our office will make sure that access to addiction treatment is not restricted by providers requiring illegal cash payments," Coakley said. "We are happy that we obtained restitution for those battling drug addiction who were allegedly taken advantage of when they needed help the most."
Suboxone is the brand name for the combination of naloxone and buprenorphine, an alternative to methadone that can only be administered daily in a federally approved clinic. Suboxone was approved for office-based treatment of opioid addiction in October 2002 by the U.S. Food and Drug Administration. Demand for Suboxone far exceeds the supply for physicians authorized to prescribe it in the state, with only approximately two percent of physicians gaining authorization. Some physicians have taken advantage of the supply-demand imbalance by charging patients and receiving the MassHealth reimbursement for treatment with Suboxone.
MassHealth members may only be charged small co-payments for certain inpatient hospital stays and drugs. Physicians may not charge co-payments to members of MassHealth for office visits.
Under the terms of the assurance of discontinuance, Bock agreed not to charge administrative fees to MassHealth members or to charge, solicit or receive any money from MassHealth members for any service payable by MassHealth. As part of the agreement, Bock does not admit or deny Coakley or MassHealth's allegations.