AG Healey Sues Treatment Center for Illegally Profiting Off of Patients Seeking Treatment for Opiate Addiction
Center for Psychiatric Medicine Unlawfully Charged Patients for Suboxone Treatment Covered Under MassHealth
SALEM – A North Andover treatment center has been sued for unlawfully profiting off of patients seeking treatment for opiate addiction, charging hundreds of dollars per visit and allowing them to avoid counseling services, Attorney General Maura Healey announced today.
“We allege this treatment center knowingly took advantage of patients by forcing them to pay exorbitant and unnecessary fees for opiate addiction services,” AG Healey said. “Comprehensive and affordable treatment is critical for those struggling with addiction. This medical practice imposed illegal barriers for hundreds of patients desperately in need of help.”
The civil complaint, filed today in Essex Superior Court against the Center for Psychiatric Medicine (CPM), alleges that since October 2010, the business increased its profit by charging hundreds of its patients cash fees to receive Suboxone treatment, a medication covered by MassHealth that is used to treat narcotic opiate addiction under a physician’s supervision. Patients were also allegedly told by CPM that they could avoid required weekly therapy sessions and monthly physician visits by paying cash instead.
CPM charged patients fees as high as $325 in cash for an initial visit and between $150 and $200 in cash for each subsequent visit, when they should not have been charged at all. MassHealth would have reimbursed anywhere from $15-$75 for these claims. Providers are required by law to only accept payments from MassHealth for services to the plan’s members.
According to investigators, CPM staff had allegedly told new patients that the center did not accept MassHealth for Suboxone treatment and that their program was cash only. The AG’s Office estimates that CPM unlawfully obtained hundreds of thousands of dollars in payments from patients.
Documents obtained in the AG’s investigation also revealed that patients were allegedly required to sign a waiver form, stating that they agreed to pay in cash for their Suboxone treatment. Prior to the waiver, CPM discussed the cash policy verbally with patients.
The civil complaint against CPM seeks restitution for the victims, civil penalties, attorneys' fees, costs and injunctive relief as a result of violations of MassHealth regulations.
A preliminary injunction hearing has been scheduled for April 28 in Essex Superior Court. The AG’s Office is seeking to obtain a court order that would prohibit CPM from charging patients cash, and prohibit the center from removing any current MassHealth patients from its Suboxone program that is required to include comprehensive counseling services.
“MassHealth members will suffer irreparable harm, namely, potential withdrawal symptoms, and potential relapse and renewed illegal use of opioids because of the lack of Suboxone treatment for their opioid dependency,” according to the complaint.
According to the complaint, CPM is a MassHealth provider that currently employs nine physicians who are legally authorized to prescribe Suboxone. In addition to substance abuse treatment, CPM also provides services involving psychiatric evaluations, psychiatric medication management, psychological testing and individual therapy.
This matter is being handled by Assistant Attorney General Jennifer Goldstein and Investigator Christopher Cecchini of AG Healey’s Medicaid Fraud Division.