Molina settles claims of MassHealth fraud, improper licensure of healthcare staff for $4.6M

The Justice Department said Molina Healthcare and former subsidiary Pathways of Massachusetts have agreed to pay a settlement of $4.625 million over allegations of False Claims Act violations and improper licensure and supervision of healthcare employees.

Between November 2015 and March 2018, Molina owned and operated Pathways, a group of mental health centers, in Springfield and Worcester, Mass. Federal and state officials allege that the two entities improperly submitted reimbursement claims to the state's Medicaid program, MassHealth, and associated organizations, according to a June 21 news release.

Additionally, the government claims that the payer failed to properly license and supervise Pathways employees, including social workers and psychological associates. The allegations also say the company failed "to provide and timely document the provision of adequate clinical supervision to clinicians requiring supervision."  

The settlement resolves allegations of False Claims Act violations brought forth by whistleblowers through a lawsuit.

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