BOSTON, Mass. (WWLP)– The Montachusett Regional Transportation Authority (MART), a transportation provider for MassHealth, has agreed to pay $300,000 settlement after allegations that they violated the False Claims Act by submitting fraudulent reimbursement claims for rides they did not provide.
U.S. Attorney Andrew E. Lelling, Massachusetts Attorney General Maura Healey, U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) Special Agent in Charge (SAC) Philip A. Coyne and FBI Boston SAC Joseph R. Bonavolonta made the announcement Tuesday.
As part of the health coverage plan, MassHealth must provide its members with non-emergency transportation to and from medical appointments. MART is one of several MassHealth transportation providers across the state. MART in turn contracts with third-party transportation companies to provide those rides. 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 Department of Justice (DOJ) 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 failed to prevent transportation companies from submitting false invoices to MART, resulting in MART then billing the invoiced amounts to MassHealth.