Newton doctor who overbilled Medicare, MassHealth agrees to pay $680,000 fine
A Newton doctor specializing in geriatric medicine has agreed to pay a $680,000 fine for overbilling government-run insurers Medicare and MassHealth for services rendered to nursing home patients, according to US Attorney Andrew E. Lelling’s office.
Lelling’s office said that according to a settlement agreement, authorities contend that Dr. Hooshang Poor submitted inflated claims for care between June 1, 2011, and May 31, 2017.
“Dr. Poor enriched himself at taxpayer expense by improperly billing Medicare and Medicaid,” Lelling said in a statement. “We will continue to work with our law enforcement partners to ensure that federal and state health care dollars are spent properly.”
His words were echoed by Phillip M. Coyne, special agent in charge of the US Department of Health and Human Services Office of Inspector General.
“It’s our agency’s mission to ensure government health funds are spent properly,” Coyne said in a statement. “Working with our Federal and State partners, we will continue to hold accountable any medical professional who bills Medicare and Medicaid for more intensive and expensive services than those actually provided.”
Under terms of the settlement with the federal government and state officials, Poor will fork over $265,896 to the Medicare program and $414,103 to MassHealth, prosecutors said.
“This doctor stole hundreds of thousands of dollars from MassHealth — taking away health care resources for those who are most in need,” state Attorney General Maura Healey said in a separate release put out by her office. “We will continue to take action to defend the integrity of MassHealth and protect Massachusetts residents.”
Healey’s office said Poor “has also agreed to be subject to a comprehensive compliance program implemented and overseen by an independent compliance monitor. This program will require Poor to update policies, procedures, and employee trainings to address his coding and billing practices, and will further require annual on-site audits of Poor’s compliance with state and federal laws for the next three years.”