AG: National addiction treatment center settles suit for allegedly filing false Medicaid and Medicare claims

News

BOSTON, Mass. (MassGOV)– A national addiction treatment center chain has agreed to pay a total of $4.5 million to the state’s Medicaid program, known as MassHealth, and Medicare to resolve allegations that the company submitted false claims for urine drug tests that were medically unnecessary and were illegally performed at the company’s own laboratory. This resolution is the first civil settlement under the Massachusetts clinical laboratory anti-self-referral law, originally proposed by the AG’s Office.

The AG’s Office and the U.S. Attorney’s Office (USAO) negotiated these settlements with Total Wellness Centers, LLC, CleanSlate Centers, Inc., and CleanSlate Centers, LLC (collectively, “CleanSlate”), and the founder and former company owner Dr. Amanda Louise Wilson, to resolve lawsuits from both the AG’s Office and a whistleblower alleging violations of the False Claims Act and federal and state self-referral statutes with respect to CleanSlate’s Massachusetts patients.

“As we face a worsening opioid crisis in Massachusetts, it’s important that treatment centers follow the rules and not cut corners to increase their bottom line,” said AG Healey. “Our resolution with CleanSlate will bring millions of dollars back to the state and implement the oversight needed to protect patients and prevent these violations from happening again. We are grateful to our federal partners for their work to help bring accountability in this case, and to the whistleblower for bringing these issues to our attention.”

The AG’s lawsuit alleged that CleanSlate required patients, depending on their stage of substance use disorder treatment, to submit to a variety of urine drug tests, some of which were medically unnecessary, causing false claims to be submitted to MassHealth. The AG’s complaint also alleged that the company’s policies, which directed clinicians at CleanSlate to refer laboratory work to its own Holyoke laboratory, violated federal and state self-referral statutes. Dr. Wilson owned both the clinic and laboratory in Massachusetts and developed the policies directing the self-referrals.

According to the AG’s Office, from 2011 through 2016, CleanSlate and Dr. Wilson also engaged in practices that led to backdating of prescriptions for Suboxone by physicians, causing the submission of false claims. After MassHealth patients had already picked up prescriptions that were sent to pharmacies by midlevel clinicians, CleanSlate physicians later reviewed the notes from the patient visits and backdated the prescriptions to the office visit dates. CleanSlate previously resolved similar allegations involving Medicare in a 2016 settlement with the USAO.

These allegations against CleanSlate were originally made in a case filed in April 2017 under the whistleblower (or qui tam) provision of the False Claims Act by a former employee of CleanSlate. The Act permits private parties to sue for fraud on behalf of the government, and it also permits federal and state governments to intervene in such actions, as Massachusetts has done in this case, which is captioned U.S. et al. ex rel. Wendy Welch v. CleanSlate Centers, Inc., et al.;Civil Action No. 17-CV-30038-MGM (D. Mass.).

CleanSlate owns and operates many opioid treatment centers in Massachusetts and around the country, where individuals receive medication-assisted treatment for substance use disorders. Locations in Massachusetts include Athol, Boston, Falmouth, West Springfield, and Worcester. CleanSlate also owns and operates an independent clinical laboratory in Holyoke where it performs tests of clinical specimens for its patients.

Under the terms of the AG’s settlement agreement, CleanSlate and Dr. Wilson will pay a total of $3.2 million to MassHealth. CleanSlate will also enter into an independent compliance program with annual audits that will be reported to the AG’s Office. Dr. Wilson also agreed to separately make a payment of $8,000 to the Western Mass Training Consortium, an independent nonprofit organization that provides support to organizations that facilitate addiction recovery. Under the terms of the agreement with the USAO, CleanSlate and Dr. Wilson agreed to pay an additional $1.3 million to settle all claims involving Massachusetts Medicare members.

The anti-self-referral law (MGL Chapter 111D, Section 8 (17) and Section 8A), proposed by the AG’s Office and enacted in 2014, prohibits referrals between clinical laboratories and any entity with a direct or indirect ownership interest in the laboratory and vice versa. State law also prohibits a laboratory from testing any specimen received from an entity with an ownership interest in the laboratory. 

MassHealth patients who believe that they have experienced fraud, abuse or neglect should file a complaint online or call the AG’s Medicaid Fraud Tip Line at (617) 963-2360.

This matter was handled by Deputy Division Chief Kevin Lownds, Assistant Attorney General Gregoire Ucuz, Senior Healthcare Fraud Investigator Steven Pfister, and Investigator William Welsh, all of the AG’s Medicaid Fraud Division, and Project Manager Catherine Madden, of the AG’s Policy and Government Division, with substantial assistance from the U.S. Department of Health and Human Services, Office of the Inspector General, and MassHealth.

The Medicaid Fraud Division of the Massachusetts Attorney General’s Office 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.

Copyright 2022 Nexstar Media Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

Only on WWLP.com | Digital First

More Digital First

Trending Stories