Press Release  Wellesley Dental Provider and Billing Agent to Pay $1.5 Million to Resolve Allegations of Improper Billing

Boston — A Wellesley-based dental provider and its billing agent have agreed to pay $1.5 million to the state’s Medicaid program (MassHealth) to resolve allegations of improper billing for visits to MassHealth members living in nursing homes, Attorney General Maura Healey announced today. 

The settlement resolves allegations that dental provider Alec H. Jaret, DMD, PC d/b/a HealthDrive Dental Group and its billing agent, HealthDrive Corporation, overbilled MassHealth for nursing home visits.

The AG’s Office filed a complaint against the defendants in March 2014 alleging that between July 2010 and September 2013, HealthDrive, on behalf of HealthDrive Dental Group, overbilled MassHealth for nursing home visits by charging a separate “house call” fee for multiple patients treated at the same facility on the same day. 

While providers can submit claims to MassHealth for covered dental services provided to each individual patient on the same day, MassHealth regulations limit the separate “house call” charge to one per facility per day, regardless of the number of patients who receive dental care. 

An investigation by the AG’s Office revealed that HealthDrive was paid for more than 34,700 excessive claims on a per-patient per-day basis, contrary to MassHealth’s regulations on dental house calls established in 2010. The parties have reached a civil settlement agreement pursuant to which HealthDrive and HealthDrive Dental Group will pay MassHealth $1,500,756 to resolve all claims.

This case was handled by Assistant Attorneys General Jennifer Goldstein, Alexandra Brazier and Robert Patten and Investigator Eric Panicucci, all of AG Healey’s Medicaid Fraud Division. MassHealth provided assistance with the case.

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