By Matt Kuhrt
In Massachusetts, two doctors have reached an agreement with the state Attorney General's office to pay $445,720 in aggregated fines and restitution for overcharging low-income patients who were receiving treatment for opioid addiction, according to an article at Boston.com.
The doctors involved were Joshua Golden, M.D., a psychiatrist with practices in Sharon and Attleboro, and Masoud Shahidi, M.D., a pediatrician at Dedham Family Medical, P.C., who also treats addiction patients. In both cases, the doctors allegedly charged patients directly for Suboxone treatments. Golden is also alleged to have charged an additional fee for follow-up visits.
Such treatments are covered by the state's MassHealth insurance program, which requires doctors to accept insurance reimbursements as payment in full, without soliciting additional fees from their patients. Golden agreed to pay $288,150 in restitution to his patients, plus another $75,000 in penalties to the state. Shahidi will repay $57,570 to his patients, as well as $25,000 to the state.
As part of their agreement with the Attorney General, the doctors will also post signs at the front desks in each of their offices informing patients that they cannot be charged for treatment if they are MassHealth members.
That patients might be unaware of the extent of insurance coverage for their treatments could have to do with the ongoing struggle to get insurers to cover substance abuse services at all.
Fortunately, recent efforts to encourage the treatment of opioid addiction as a chronic disease may finally be getting some traction with insurance companies, according to a FierceHealthPayer article about increased insurance coverage in Massachusetts.
Increasing patient awareness should help get those who need it to solicit care, as well as making it more difficult for physicians to game the system.
To learn more:
- read the Boston.com article