Transportation Broker For MassHealth Agrees to Pay $300,000 to Resolve False Claims Allegations
Montachusett Regional Transportation Authority allegedly submitted reimbursement claims for transportation that was never provided
BOSTON – The Montachusett Regional Transportation Authority (MART), a transportation broker for MassHealth, has agreed to pay $300,000 to resolve allegations that it violated the False Claims Act by submitting reimbursement claims for rides that never happened.
As a state Medicaid program, which the federal government jointly finances, MassHealth must provide its members with non-emergency transportation to and from medical appointments that MassHealth covers. MassHealth uses transportation brokers, including MART, to help its members find these rides. MART in turn contracts with third-party transportation companies to provide rides to MassHealth members. MART pays the transportation companies for the rides and submits reimbursement claims to MassHealth for the costs of the rides. In addition, MassHealth’s parent agency, the Executive Office of Health and Human Services (EOHHS), pays MART a management fee for its brokerage services.
The government alleges that, from Jan. 1, 2011 through Dec. 31, 2015, MART submitted reimbursement claims to MassHealth for thousands of rides that MART’s contracted transportation companies did not actually provide. MART’s contract with EOHHS required MART to have “procedures to verify that scheduled trips were performed as authorized and as billed, and that the Transportation Provider performed Consumer trips in a timely and satisfactory manner.” According to the allegations in the settlement agreement, however, MART’s verification procedures were not sufficient to prevent transportation companies from submitting false invoices to MART, resulting in MART then billing the invoiced amounts to MassHealth.
“MART obtained reimbursement from MassHealth for services that its vendors did not actually deliver,” said United States Attorney Andrew E. Lelling. “We expect companies doing business with the government to comply with their contractual obligations. This office will continue to pursue those responsible for undermining the benefits that the government has bargained for.”
“The Medicaid program provides health care benefits to low-income individuals and families. Billing for transportation services that were never provided is a waste of valuable taxpayer funds that are intended to provide critical services to those in need,” said Special Agent in Charge Phillip M. Coyne of the U.S. Department of Health and Human Services Office of Inspector General. “This settlement is an example of how the State and the Federal government can work together to recoup and deter overbilling practices.”
“Not only did the Montachusett Regional Transportation Authority try to steal from a government program intended to support a vulnerable population, but they saddled taxpayers with the bills,” said Joseph R. Bonavolonta, Special Agent in Charge of the Federal Bureau of Investigation, Boston Division. “Today’s settlement underscores the FBI’s commitment to working with our law enforcement partners in rooting out Medicaid fraud and ensuring that businesses aren’t taking more than what they have legitimately earned.”
U.S. Attorney Lelling, Massachusetts Attorney General Maura Healey, HHS-OIG SAC Coyne and FBI Boston SAC Bonavolonta made the announcement today. The matter was handled by Assistant U.S. Attorney Evan Panich of Lelling’s Office.