Press Release  Norfolk Medical Practice Settles Claims of Illegally Charging Cash for Suboxone

Boston — A Norfolk practice, two of its doctors and one former doctor will pay $150,000 to resolve allegations that they charged cash for a substance use disorder treatment already covered by the state’s Medicaid Program (MassHealth), Attorney General Maura Healey announced today.

Under the terms of the settlement agreement, Pondville Medical Associates LLC, and three doctors associated with the practice, Riad Mortada, Ahmed Basheer, and Rezene Berhane, will pay $150,000 to resolve allegations that from April 2011 through September 2016, they knowingly solicited and charged patients cash out-of-pocket for Suboxone treatment instead of billing their treatment to MassHealth. Of these settlement funds, more than $100,000 will be used to provide restitution to MassHealth members who were illegally charged cash for Suboxone.

“This illegal practice put up barriers to patients seeking lifesaving opioid treatment and violated MassHealth regulations and state laws,” said AG Healey. “This behavior could have had fatal consequences, and we will not tolerate companies that seek to maximize profits by taking advantage of patients.”

By law, MassHealth providers are required to accept payments from MassHealth as payment in full for substance use treatment services provided to MassHealth recipients. Suboxone, as well as other formulations of buprenorphine, is used for the treatment of opioid dependence as it suppresses 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 substance use disorder treatment and continues to actively investigate and prosecute such cases throughout the state. In January, the AG’s Office secured a guilty plea for a Dorchester doctor who charged cash for Suboxone.

In November 2017, AG Healey sent a letter alerting doctors who provide substance use disorder treatment that the office will take action against those who unlawfully require cash payments from MassHealth members for covered treatments.

Members of the public who are aware of similar practices by other physicians should call the Attorney General’s Medicaid Fraud Division at (617) 963-2360 or file a complaint through the Attorney General’s website.

This matter was handled by Assistant Attorney General Christina Chan, Investigations Supervisor Dean Bates and Investigator William Welsh, of AG Healey’s Medicaid Fraud Division.

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