Commonwealth v. HealthDrive Corporation, et al. (Lawyers Weekly No. 12-140-16)

1 COMMONWEALTH OF MASSACHUSETTS SUFFOLK, ss. SUPERIOR COURT SUCV2014-00772-BLS2 COMMONWEALTH OF MASSACHUSETTS Plaintiff vs. HEALTHDRIVE CORPORATION & ALEC H. JARET, D.M.D., P.C., Defendants MEMORANDUM OF DECISION AND ORDER ON (1) COMMONWEALTH’S MOTION FOR PARTIAL SUMMARY JUDGMENT AGAINST DEFENDANT ALEC H. JARET, D.M.D., P.C., D/B/A HEALTHDRIVE DENTAL GROUP AND (2) DEFENDANTS’ CROSS MOTION FOR PARTIAL SUMMARY JUDGMENT The Commonwealth of Massachusetts filed this action against defendants HealthDrive Corporation (HealthDrive) and Alec H. Jaret, D.M.D., P.C. (Jaret) seeking to recover alleged overpayments of approximately $ 1.1 million made by the Massachusetts Medicaid agency MassHealth in connection with dental “house calls” made to certain MassHealth members. The case is now before the Court on cross motions for partial summary judgment as to Count I of the Commonwealth’s Second Amended Complaint. That Count seeks to recover the alleged overpayments under regulations which require a provider to reimburse MassHealth in the event that it is paid more than it is legally entitled to receive. 130 C.M.R. §450.260(A), §450.237. The defendants also move for summary judgment in their favor on Counts X through XIII1 and, if this Court determines that they are entitled to retain the payments at issue, they seek dismissal of the remaining claims asserted against them. After careful review of the summary judgment 1 These Counts are all equitable in nature and are based on the same allegations as Count I. The Commonwealth does not move for summary judgment on these counts, however, because they are not available as equitable remedies if the regulation at issue is valid such that the Commonwealth has a remedy at law. 2 record, this Court concludes that the Commonwealth’s motion must be Allowed and the defendants’ motion must be Denied. BACKGROUND The summary judgment record reveals the following material facts. MassHealth is the Massachusetts Medicaid program and is administered by the Executive Office of Health and Human Services. It is a cooperative federal and state undertaking that provides payment for medical services to individuals and families unable to pay for their own medical care. Included in the care that MassHealth pays for are dental services for certain low income people. HealthDrive is a Delaware corporation that, in exchange for a monthly fee, provides business, management, and administrative assistance to health care providers who service geriatric populations living in long-term care facilities. Jaret is one of those providers, furnishing dental services to people covered under MassHealth who live in nursing homes or similar facilities. Pursuant to the agreement that Jaret has with HealthDrive, Health Drive submits claims to MassHealth on behalf of Jaret. Jaret and others like it enter into contracts with MassHealth in order to be reimbursed for the services they render. 130 C.M.R. §450.101. In those […]

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