Press Release  AG Healey Warns MassHealth Providers Against Illegally Charging Patients for Opioid Addiction Treatment

Boston — Attorney General Maura Healey has sent a letter to doctors who provide addiction treatment services through the state’s Medicaid program, MassHealth, warning them against unlawfully charging people struggling with opioid addiction and vowed to take immediate and aggressive action against those who try to illegally profit off of vulnerable patients in Massachusetts.

MassHealth providers are required by law to accept payments from MassHealth as full payment for substance use treatment services. Suboxone and other formulations of buprenorphine are used to treat opioid addiction by suppressing withdrawal and cravings for opioids.

The AG’s Office has brought numerous criminal and civil enforcement actions against MassHealth providers who solicited and received cash payments from MassHealth members for covered addiction treatments and continues to actively investigate and prosecute such cases throughout the state.

“Providers who illegally charge patients for opioid treatments could be adding to the death toll caused by this epidemic,” said AG Healey. “This extra cost can prevent those struggling with addiction from getting assistance that could save their lives. Our office is sending this letter as a warning to providers that those imposing extra charges for Suboxone treatment will be prosecuted.”

The AG’s Medicaid Fraud Division works to combat fraud in the MassHealth program and to reduce barriers to treatment. The division investigates complaints about substance use disorder providers who solicit and receive excess payments from MassHealth members for covered treatments, such as Suboxone, Subutex, and Vivitrol.

“We work closely with the Attorney General to protect MassHealth members from predatory practices,” said Health and Human Services Secretary Marylou Sudders. “MassHealth is committed to increasing the availability of medication assisted treatment, like Suboxone, for members with opioid use disorders and ensuring that providers are delivering safe, essential treatment.”

“There is no place in Massachusetts for addiction treatment providers who prey on MassHealth clients in desperate need of treatment,” said Michael Botticelli, Executive Director of the Grayken Center for Addiction Medicine. “The AG continues to take strong action to protect the health and safety of Massachusetts residents.”

“This has been an ongoing issue for many years and we are encouraged to see AG Healey release this warning,” said Joanne Peterson, Founder and Executive Director of Learn to Cope. “We have often wondered how this still happens today after all these years but it does. A patient should have access to treatment without having to pay when they have insurance to cover their medication.”

In Massachusetts, opioid overdoses kill on average more than five people every day. The Massachusetts Department of Public Health estimates that more than 2,000 people – the highest number ever recorded in the state and a 17 percent increase from 2015 – died from opioid-related overdoses in 2016. Massachusetts has lost over 5,000 people to opioid overdoses in the last three years.

This letter to providers is another way AG Healey is working to address the addiction crisis in Massachusetts.

Last month, AG Healey announced that her office has expanded an ongoing investigation into the marketing and sale of opioids to include multiple manufacturers of branded painkillers and three major drug distributors to help uncover the roots of the epidemic.

AG Healey and the GE Foundation also recently announced a $2 million public-private initiative – named Project Here – that this fall will bring substance use prevention resources to students in every public middle school in Massachusetts to help address the opioid epidemic.

This past spring, the AG’s Office distributed $700,000 in settlement funding directly to school districts, nonprofits and community organizations to fund prevention programming through its Youth Opioid Prevention Grant Program.

AG Healey recently announced that her office is committing a $1 million grant from the U.S. Department of Justice to a new Fentanyl Strike Force, which in partnership with the Massachusetts State Police, targets heroin and fentanyl traffickers and dismantles their distribution networks across Massachusetts. The funds expand the AG’s Office’s own drug enforcement work – which has increased sixfold since 2015 – and help build enhanced partnerships with federal, state, and local law enforcement.

The AG’s Office also worked with the Legislature and DPH to create a state fund that allows our cities and towns to buy Narcan at a heavily discounted price, and is working to keep that fund as a resource for as long as it is needed.

The AG’s Office continues to examine a host of other activities and practices that contribute to the opioid crisis, from criminal drug trafficking to barriers to substance use treatment.

To report suspected fraud, please contact the AG’s Medicaid Fraud Hotline at (617) 963-2360 or file a report online.

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