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Dorchester doctor charged with making patients pay for addiction drug the state then also paid him for
By adamg on Thu, 09/28/2017 - 4:49pm
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.
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Comments
street drugs or doctor drugs
This is not news to those of us who have been working with and treating those impacted by drug addiction. There are plenty of learning tools out necessary for sobriety and doctors and other providers who try and offer even more addictive medicine to "treat" one's addiction more often than not enables it. This of course is reinforced by NIMH, NIDA, ASAM and the drug companies. I have begged my patients for over 3 years to steer clear of the good Doctor Patel. Doctors have become "medication managers" who are very quick to medicate before they
even consider the idea to communicate.
Reprehensible
Not just greedy, but evil.
"even more addictive medicine"
Please tell us: is your alternative GOD or something? Because you have done nothing but spew misinformation and scientifically invalid nonsense here.
This is another example how
This is another example how so many doctors are still ignorant when it comes to their patients whoare addicts. From my own experience, they treat you like you are uneducated, never had a good job, too stupid to realize a scam, etc. Well, who's the stupid one now, Mr. Patel?
Doc Patel had an addiction..
.. to moola.
cannot understand
why a prescribing physician would take these kinds of risks. the way the public thinks of mental health remains largely this: take medication for discomfort and don't talk about it. yes, in this town, there are many people who are psychotherapy--talk therapy--customers. there are also a lot of people who believe the stigma that mental life is risky--too risky to discuss at length--and like the rest of America they would prefer to only take medication.
due to the demand for medication, any psychiatrist has the biggest caseload they want to take on. why would any doctor risk litigation against their practice for a few extra thousand dollars?
Speculating
Gambling addiction?
Student-loan debt?
Spendy spouse?
Mansion mortgage?
Blackmail victim?
Greedy lizard-man?
Billing
I believe it's called "Double back billing". When caught Providers pay a fine and move on to the next victim. When caught they should be prosecuted and jailed.
Rules of Acquisition
Judging from the doctor's last name, culture is probably part of it.
Patels are literally the Ferengis of India.
You forgot
Alimony payments?
Child support?
Perruptor's list is a pretty
Perruptor's list is a pretty good one (I would add "Personality Disorder", but that maybe is a synonym for Greedy Lizard-Person? Still haven't caught up with the P/D changes in DSM5), and I don't mean to excuse anything – this is reprehensible – yet: please be aware that the sort of doctor who would be prescribing addiction meds like Vivitrol is a psychiatrist, and he would be billing for 15 minute psychiatric med management sessions CPT codes 99212, 99213, or 99214 (that's what you're allowed on MassHealth and most insurers), and the compensation for outpatient psychiatric med management appointments is peanuts.
In particular, last I checked (a few years ago) the going rate for hiring a contract psychiatrist to work at your clinic part time in the Boston area was a minimum of $250/hr. But the typical payment for a 15 minute med management session is $50. So if a psychiatrist sees four patients an hour, they make $200/hr. In other words, even seeing an insane number of patients a day, a psychiatrist can't earn for a clinic as much as they cost the clinic at the bottom of the going rate for psychiatrists.
At the clinics I have worked (I'm a mental health professional, not a psychiatrist) the psychiatrists were loss leaders. The clinic lost money on every patient session the psychiatrist saw, made it up out of the reimbursal for counselors. Or failed to make it up - I just found out that a clinic I left a couple years ago shut down this past summer.
This is also why it's so damned hard for patients to find psychiatrists in this town; clinics can't hire them, because they can't pay anywhere near as well as hospitals (for inpatient psychiatric care), and the few psychiatrists left in private practice are not taking MassHealth or even insurance at all. Something like 50% of psychiatrists have stopped taking insurance, because it doesn't pay enough.
This guy is a total ass, who basically used vulnerable, desperate people's addictions to extort money from them. At the same time, please make no mistake, the financial situation of psychiatry is beyond fucked up.