Auditor Bump Finds MassHealth Paying Doctors Prohibited by Feds
State Auditor Suzanne Bump. Courtesy Photo
State Auditor Suzanne Bump has found that MassHealth, the commonwealth’s Medicaid program, has made nearly half a million dollars in payments to doctors prohibited by the federal government from participating in the program.
“In discussions with our colleagues in other states, we learned this is a problem throughout the country so we conducted data analytics to determine whether the problem existed here. That analysis turned up a sufficient level of concern that led us to conduct this audit,” Bump said in a statement Wednesday.
Bump’s office found that 12 providers, banned from participating in MassHealth for federal violations including patient abuse and healthcare fraud, were paid $476,787 for 5,534 claims for medical services and prescriptions.
“The inclusion of prohibited providers in the MassHealth program represents a violation of public trust,” Bump said. “MassHealth must quickly address this issue in order to ensure the safety of program participants.”
The audit also found that MassHealth paid $50,682 for 3,445 pharmacy claims for prescriptions written by seven prohibited providers. Of these prescriptions, 330 were for opiates and amphetamines.
