Patrick-Murray Administration's Division of Professional Licensure Creates Health Care Fraud Tip Line
Initiative increases oversight of excessive or false billing practices
Consumers can call the Health Care Fraud Unit's hotline at (617) 727-4499 and leave a confidential message, and if they so desire, remain anonymous.
"As our administration works collaboratively across state agencies to address and eliminate fraud and wasteful spending, it is encouraging to have the Division of Professional Licensure think proactively and create this new Health Care Fraud Tip Line," said Lieutenant Governor Timothy Murray, Chair of the Anti-Fraud, Waste and Abuse Task Force. "This hotline is another example of our efforts to protect our taxpayer dollars and be good fiscal stewards."
The Division of Professional Licensure oversees a number of health-related licensed professions, including athletic trainers, chiropractors, occupational therapists and physical therapists. Last year, the Division's boards took disciplinary action against 46 licensees found in violation of billing statutes and regulations.
"Our investigators are constantly inspecting and reviewing licensees, including for potential fraudulent billing practices, but patients can be the first to notice irregularities and this tip line gives consumers a safe, accessible way to alert us to issues," said Mark Kmetz, the Director of the Division of Professional Licensure. "By calling our tip line, consumers can be assured their concerns are being examined quickly and professionally by our investigators."
The Division of Professional Licensure includes a Health Care Fraud Unit, which works not only with Division boards, but also with the Division of Insurance, the Executive Office of Health and Human Services and the Attorney General's Office on combating fraud committed by health care professionals and facilities. Tips received on the line unrelated to DPL boards will be referred to the appropriate agency.
Along with excessive or false billing, the DPL Health Care Fraud Unit also investigates complaints regarding improper referral relationships; charging for services not rendered; selling or sharing provider numbers; offering incentives to beneficiaries; and making false claims about credentials, diagnosis codes, and medical conditions, care and results.
"Billing fraud taxes our entire health care system by adding costs paid for by all consumers. Combating this fraud helps reduce unnecessary strain on health care costs," said Barbara Anthony, the Undersecretary of the Office of Consumer Affairs and Business Regulation, which oversees the Division of Professional Licensure. "Licensees need to know that they cannot game the system without suffering the repercussions."
Health-related fields regulated by the Division of Professional Licensure include:
- Allied Health Professionals (athletic trainers, occupational therapists, physical therapists)
- Allied Mental Health and Human Services (mental health counselors, marriage and family therapists, rehabilitations counselors, education psychologists)
- Dieticians and Nutritionists
- Dispensing Opticians
- Hearing Instrument Specialists
- Massage Therapists
- Speech-Language Pathologists and Audiologists
For more on the Health Care Fraud Unit, visit the Division of Professional Licensure's website. The Division of Professional Licensure is a regulatory agency responsible for ensuring regulatory compliance and the integrity of the licensing process for approximately 365,000 licensees in the trades and professions under the jurisdiction of 31 Boards of Registration. The Division of Professional Licensure is an agency within the Office of Consumer Affairs and Business Regulation. Follow the Office at www.mass.gov/consumer, its Consumer Connections Blog and at its Twitter feed, @Mass_Consumer.