PE Firm Pays Record Settlement for Allegedly Deficient Health Services: Identifying Traps for the Unwary

In a Press Release issued on October 14 2021 by the Office of Massachusetts Attorney General Maura Healy, a potentially groundbreaking settlement was announced. Below is an excerpt from the release, followed by our takeaways.

“In the largest settlement of its kind, a private equity (PE) firm and former executives of South Bay Mental Health Center, Inc. (SBMHC) have agreed to pay $25 million for allegedly causing fraudulent claims to be submitted to the state’s Medicaid Program, known as MassHealth, for mental health care services provided to patients by unlicensed, unqualified, and improperly supervised staff members at clinics across the state.

This settlement is the largest publicly disclosed government health care fraud settlement in the nation involving private equity oversight of health care providers, as well as the largest amount a private equity company itself has agreed to pay to resolve fraud allegations involving health care portfolio companies. It is also the biggest Massachusetts-only Medicaid Fraud settlement.

Source: PE Firm Pays Record Settlement for Allegedly Deficient Health Services: Identifying Traps for the Unwary / The National Law Review

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