BROCKTON A Brockton-based mental health provider agreed to pay $700,000 in a settlement to resolve allegations that he submitted false reports to MassHealth following an investigation by the district attorney’s office General of Massachusetts.
The settlement with Luminosity Behavioral Health Services Inc. (Luminosity) resolves allegations that Luminosity billed MassHealth for higher levels of services than those actually provided and billed MassHealth using an additional code that was not applicable to the services it provided. he had returned, said Attorney General Andrea Joy Campbell. said in a written statement.
Luminosity Behavioral Health Services Inc., located at 157 Main St., offers outpatient mental health and substance abuse services to anyone struggling with life’s challenges, according to its website.
More than two million Massachusetts residents rely on public funds available through the MassHealth program to cover essential health care services, including critical mental health services, Campbell said. My office will continue to advocate for vulnerable communities in need of such services, protect public funds, and maintain the integrity of the MassHealth program.
The prosecutors’ office said the investigation began with a referral to MassHealth and its managed care entities. The investigation found that Luminosity submitted claims to MassHealth and MassHealth managed care entities by “using billing codes that overstated the duration, breadth and scope of the services it provided to MassHealth members and falsely inflated the amount of payment claimed for these services,” the statement said.
The Attorney General’s investigation also found that Luminosity knowingly submitted claims to MassHealth and managed care entities for services using a certain billing code when the services rendered did not meet the description of that code.
In addition to the financial settlement, under the terms of the agreement, Luminosity has agreed to implement at its own expense a three-year independent compliance monitoring program, which will result in updates to its policies and procedures, new training for employees and periodic audits. to ensure it complies with federal and state laws, the AG’s office said.
This case was handled by Assistant Attorney General Matthew Jones, Lead Health Care Fraud Investigator William Welsh, and Investigator Julia Galvao, all of the AG’s Medicaid Fraud Division. MassHealth and its managed care entities provided substantial assistance in the investigation.
The Massachusetts Medicaid Fraud Division receives 75% of its funding from the U.S. Department of Health and Human Services as part of a grant totaling $5,865,996 for federal fiscal year 2024. The remaining 25%, totaling $1,955,330 $ for FY 2024, are funded by the Commonwealth of Massachusetts. , according to the AG’s office.
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