BROCKTON – A Brockton-based mental health provider has agreed to pay $700,000 in a settlement to resolve allegations that it filed false claims with MassHealth following a MassHealth investigation. . Massachusetts Attorney General’s Office.
“The settlement with Luminosity Behavioral Health Services Inc. (Luminosity) allows Luminosity to bill MassHealth for a higher level of services than it actually provided and to bill MassHealth using additional codes that do not apply to the services provided. The allegation that he did so has been resolved,” said Attorney General Andrea. Joy Campbell said in a written statement.
Luminosity Behavioral Health Services Inc., 157 Main St., provides outpatient mental health and addiction services to “anyone struggling to cope with life’s challenges.” According to the website.
“More than 2 million Massachusetts residents rely on public funds available through the MassHealth program to cover essential health care services, including critical mental health services,” Campbell said. “My office will continue to support vulnerable communities that need such services, protect public funds, and maintain the integrity of mass health programs.”
The AG’s office said the investigation began with a referral from MassHealth and its managed care organizations. As a result of the investigation, Luminosity accused MassHealth and MassHealth managed care providers of “using billing codes that exaggerated the length, scope, and extent of services provided to MassHealth members and falsely inflated the amounts billed for these services.” It has been determined that a claim has been filed, the statement said. Say.
The Attorney General’s investigation also found that Luminosity knowingly submitted claims for services to MassHealth and managed care organizations using certain billing codes when the services provided did not meet that code’s description. .
In addition to the financial settlement, under the terms of the agreement, Luminosity agreed to conduct a three-year independent compliance monitoring program at its own expense. This results in updated policies and procedures, new training for employees, and regular audits. The AG’s office said this is to ensure compliance with federal and state laws.
This matter was handled by Assistant Attorney General Matthew Jones, Senior Health Care Fraud Investigator William Welsh, and Investigator Julia Galvao of the AG’s Medicaid Fraud Division. MassHealth and its managed care organizations provided significant support for the study.
The Massachusetts Medicaid Fraud Unit receives 75 percent of its funding from the U.S. Department of Health and Human Services in grants totaling $5,865,996 for federal fiscal year 2024. The remaining 25 percent, totaling $1,955,330 for fiscal year 2024, is funded by the Commonwealth of Massachusetts. According to the AG’s office.
Staff writer Kathy Bossa can be reached by email at [email protected]. Support local journalism by purchasing a digital or print subscription to The Enterprise today.
