Where healthcare is concerned in Massachusetts, it almost seems like a "Catch-22", doesn't it? You HAVE to have healthcare or you'll end up paying a tax penalty. But, at the same time, who protects you from being taken advantage of by the health care providers?

Thankfully, at least some of the time, justice is served. According to a media statement from the Department of Justice in Boston, Molina Healthcare, Inc., and its previously owned subsidiary, Pathways of Massachusetts, have agreed to pay over $4.5 million to resolve allegations that it violated the False Claims Act.

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United States District Attorney Rachael S. Rollins, Massachusetts Attorney General Maura Healey, and Phillip M. Coyne, Special Agent in Charge of Health and Human Services/Office of Inspector General, were among those who made the announcement yesterday.

Molina and Pathways have agreed to pay $4,625,000 to resolve allegations that it violated the False Claims Act by submitting reimbursement claims while transgressing numerous regulations regarding staff supervision and licenses.

Molina provides health care plans for, among others, MassHealth. The case alleges that during the period between November 2015 and March 2018(when Molina owned and operated Pathways, which had centers in Springfield and Worcester), both Molina and Pathways improperly submitted claims for reimbursement from MassHealth and other entities managed by MassHealth while committing several infractions.

In addition, the settlement also resolves allegations brought in a lawsuit filed by whistleblowers under certain provisions of the False Claims Act which allows private parties to bring suit on the government's behalf and to share in any recovery.

For more, check out the media statement on the Department of Justice's website here.

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