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A western Massachusetts addiction treatment group, SaVida Health PC, has agreed to pay $2 million to settle allegations of overbilling and fraudulent medical practices, according to a statement from the state’s attorney general. This settlement comes after SaVida allegedly mischarged the Medicaid program for unnecessary tests and over-represented the level of services provided during office visits.

Allegations of Overbilling and Unnecessary Tests

The Massachusetts Attorney General’s office claimed that SaVida up-coded evaluation and management office visits, leading to inflated charges for services that did not match the billings. In addition, the company allegedly billed for routine urine drug tests that were deemed medically unnecessary, further compounding the false claims made to the Medicaid program, MassHealth.

These actions, according to the AG’s office, violated both the Massachusetts False Claims Act and the Medicaid False Claims Statute. The group’s actions were considered breaches of its contracts with MassHealth and, in the attorney general’s view, amounted to unjust enrichment.

Ensuring Accountability with a Compliance Monitor

“This settlement serves as a stark reminder that those who bill taxpayer-funded programs must comply with the law,” Massachusetts Attorney General Andrea Joy Campbell said in a statement. “We will continue to protect these vital public resources and hold providers accountable to ensure fairness and transparency.”

As part of the settlement, SaVida is also required to fund an independent compliance monitor to ensure its future adherence to state and federal regulations. This monitoring program will oversee the group’s practices, including its clinical laboratory services, and guarantee they align with the necessary legal standards.

Financial Settlement Details and Cooperation

The $2 million settlement will be used to provide restitution to the MassHealth Medicaid program, compensating for the overbilled services and alleged false claims. This sum is derived from approximately $2.6 million that was withheld from SaVida since December 2023. Any remaining funds will be returned to the company.

Though the settlement resolves the case, SaVida has neither admitted nor denied the allegations. The company fully cooperated with the investigation, according to the attorney general's office, and did not face any formal court action.

Precedent Set with Previous Settlements

This settlement follows a similar case in September, when Evolve Health PC, a Quincy-based addiction treatment group, agreed to pay $650,000 in restitution after similar overbilling allegations. That case also required Evolve to implement a three-year compliance monitoring program at its expense.

SaVida Health’s legal representation, led by Kathleen McDermott, did not immediately provide a comment on the settlement.

The state's legal team was led by Natalie Rutkowski from the Massachusetts Attorney General’s Office.