Press Release  AG Healey Secures $800,000 From Jamaica Plain Pharmacy Over Unlawful Auto-Refill Practices and Billing MassHealth for Prescriptions That Were Not Provided

BOSTON — Attorney General Maura Healey today announced an $800,000 settlement with a retail pharmacy in Jamaica Plain for allegedly billing the state’s Medicaid program, MassHealth, for automatically refilled prescription medications, for a costly prescription multivitamin that was not provided to patients, and other prescriptions that were not authorized by a physician.

Pursuant to the terms of the settlement agreement, Sun Health Systems, LLC d/b/a Bravo Pharmacy and its owner, Dmitry Linkov will be required to pay $800,000 to resolve these allegations. The settlement also requires Bravo to implement a three-year independent compliance monitoring program to ensure future compliance with all laws, rules and regulations applicable to participation in MassHealth. 

“This pharmacy’s improper billing and automatic refill practices resulted in unnecessary overpayments by MassHealth,” said AG Healey. “This resolution brings money back to our state, puts an end to these unlawful practices, and requires strict compliance with state and federal regulations moving forward.”

According to the AG’s investigation, from May 2017 through July 2021, Bravo allegedly submitted numerous claims for an uncommonly used and expensive vitamin supplement known as Hylavite that was not provided to patients. At the time, MassHealth’s rate of reimbursement for Hylavite was roughly $1,670 per 30-day supply.

The investigation into the pharmacy’s billing practices also determined that Bravo allegedly implemented an “automatic refill” program which expressly violated MassHealth regulations. Current regulations prevent any pharmacy in the Commonwealth from refilling a prescription that was not explicitly requested by a MassHealth member or caregiver at the time of each filling event. 

The settlement is one of many actions the AG’s Medicaid Fraud Division has taken to address improper automatic refill programs. Last year, a pharmacy in North Chelmsford agreed to pay $500,000. In 2019, a Colorado-based pharmacy paid $1 million to MassHealth to resolve allegations of operating an automatic refill program. In December 2018, Target agreed to pay $3 million to MassHealth to settle federal and state allegations of administering an automatic refill program.

This matter was investigated by Managing Attorney Jennifer Goldstein, Assistant Attorney General Darcy Currey, Investigations Supervisor Christopher Cecchini, Senior Health Care Fraud Investigator Christine Barker and Investigator Mirlinda Sedjiu of Attorney General Maura Healey’s Medicaid Fraud Division, with assistance from MassHealth.

The AG’s Medicaid Fraud Division receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award. The remaining 25 percent is funded by the Commonwealth of Massachusetts.

###