A grand jury today indicted Ashok Patel, a Hanover doctor with an office on the campus of Dorchester's Carney Hospital on charges he tried to earn extra money by charging patients for addiction drugs even though the state was reimbursing him for them, the state Attorney General's office reports.
Both Patel, 61, and his clinic's corporate entity were charged with two counts of larceny over $250, one count of filing false claims with Medicaid and one count of filing excess charges, all related to prescriptions he wrote for Suboxone and Vivitrol, drugs given to addicts to try to wean them off opioids.
Investigators determined that between December 2014 and August 2016, Patel solicited and received more than $15,000 in payments from MassHealth members for services that were covered by MassHealth. The investigation revealed that Patel “double dipped” by submitting more than $12,000 in claims for reimbursement from MassHealth for the same treatment services that MassHealth members had already directly paid Patel for in cash.
The AG’s Office alleges that MassHealth members unable to pay Patel’s excess charges were turned away from his clinic and did not receive necessary substance use treatment from Patel.
The investigation also exposed Patel’s upcoding scheme related to Vivitrol. Patel allegedly submitted Vivitrol reimbursement claims at a higher rate than permitted by improperly coding Vivitrol as chemotherapy, causing MassHealth to overpay Patel more than $10,000.