Attorney General Andrea Joy Campbell has reached a $2 million settlement with SaVida Health, P.C. (SaVida), a physician group specializing in behavioral health and substance use treatment services with locations across Western Massachusetts. The settlement resolves allegations that the organization submitted false claims to MassHealth and MassHealth managed care entities (MCEs) by billing MassHealth for more expensive office visits than provided and billing for medically unnecessary urine drug tests.
As part of the settlement, SaVida will pay $2 million in restitution to the Commonwealth and will implement a three-year independent compliance monitoring program at its own expense. The compliance program will result in updated policies and procedures to ensure compliance with MassHealth and MCE requirements, trainings for staff on the updated policies and procedures, and annual record and on-site audits.
SaVida owns and operates four locations in Western Massachusetts, including locations in Worcester, West Springfield, Pittsfield, and North Adams.
“My office will continue to enforce our laws so that providers play by the rules and crucial taxpayer-funded resources are protected,” said AG Campbell. “I am proud to announce this settlement, which will provide meaningful restitution of public resources to the Commonwealth and ensure compliance with state laws that enable the MassHealth program to work for all who depend on it.”
The AGO alleges that since at least 2018, SaVida “upcoded” many of its Evaluation and Management (E&M) office visits, billing MassHealth and MCEs for more expensive levels of service than were actually provided. Additionally, the AGO alleges that SaVida billed MassHealth and MCEs for routine confirmatory urine drug tests that were not medically necessary. Per explicit MassHealth guidance, health providers must only perform confirmation tests for positive results from a drug screen on an as-needed basis and only when medically necessary. Providers should not bill for confirmatory tests in lieu of drug screen services or as a routine supplement to drug screens. Savida cooperated fully with the investigation.
This matter was handled by Assistant Attorney General Natalie Rutkowski and Senior Healthcare Fraud Investigators Erica Schlain and William Welsh, each of the AGO’s Medicaid Fraud Division.
This matter is AG Campbell’s latest effort to hold accountable those who misuse roles of authority or public trust, including within the behavioral health industry and through abuse of the MassHealth program. This past October, the AGO announced a $650,000 settlement with Evolve Health, P.C., a Quincy-based physician group specializing in substance use disorder treatment, to resolve allegations of false billing to MassHealth both for confirmatory urine drug tests not provided and for more expensive levels of office visits than actually provided.
The AGO’s Medicaid Fraud Division is a Medicaid Fraud Control Unit, annually certified by the U.S. Department of Health and Human Services to investigate and prosecute health care providers who defraud the state’s Medicaid program, MassHealth. The Medicaid Fraud Division also has jurisdiction to investigate and prosecute complaints of abuse, neglect and financial exploitation of residents in long-term care facilities and of Medicaid patients in any health care setting. Individuals may file a Medicaid/MassHealth fraud complaint or report cases of abuse or neglect of Medicaid patients or long-term care residents by visiting the AGO’s website.
The Massachusetts Medicaid Fraud Division receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award totaling $5,922,320 for federal fiscal year 2025. The remaining 25 percent, totaling $1,974,102 for FY 2025, is funded by the Commonwealth of Massachusetts.
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