$275000 Settlement From Suboxone Clinic for False MassHealth Claims
Summary
The Massachusetts Attorney General's Office announced a $275,000 settlement with Elm Tree, LLC, a substance use disorder treatment clinic operating in Quincy, Lowell, and Malden, to resolve allegations of submitting false claims to MassHealth for medically unnecessary urine drug tests. In addition to the monetary payment, Elm Tree must implement new MassHealth-compliant policies and a three-year independent compliance monitoring program with annual audits reported to the AGO.
What changed
The MA Attorney General's Office reached a $275,000 settlement with Elm Tree, LLC, a substance use disorder treatment clinic, resolving allegations that the clinic submitted false claims to MassHealth for medically unnecessary urine drug tests. The settlement requires Elm Tree to pay $275,000, draft new MassHealth-compliant policies and procedures, and implement a three-year independent compliance monitoring program at its own expense with annual audits reported to the AGO.
Healthcare providers participating in MassHealth should review their urine drug testing billing practices to ensure compliance with MassHealth regulations, which require tests to be properly ordered, medically necessary, and not billed on the same date as a drug screen. The AGO's Medicaid Fraud Division indicated this case is part of ongoing efforts to protect MassHealth program integrity, suggesting heightened enforcement scrutiny of substance use disorder treatment providers billing for drug testing services.
What to do next
- Monitor for additional enforcement actions by MA AG Medicaid Fraud Division targeting MassHealth providers
- Review internal billing practices for urine drug testing to ensure MassHealth requirements are met
- Implement compliance policies if your organization treats opioid use disorder patients under MassHealth
Penalties
$275,000 settlement payment to MassHealth; mandatory three-year independent compliance monitoring program at clinic's own expense with annual audits reported to the AGO
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Apr 10, 2026GovPing captured this document from the original source. If the source has since changed or been removed, this is the text as it existed at that time.
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Press Release
Press Release AG's Office Secures $275,000 Settlement from Suboxone Clinic for Submitting False Claims to MassHealth
For immediate release: 4/09/2026
- Office of the Attorney General
Media Contact
Kennedy Sims, Deputy Press Secretary
Phone
Call Kennedy Sims, Deputy Press Secretary at (617) 727-2543
Online
Email Kennedy Sims, Deputy Press Secretary at Kennedy.Sims@mass.gov
BOSTON — The Massachusetts Attorney General’s Office (AGO) announced that it has reached a $275,000 settlement agreement with Elm Tree, LLC -- a clinic that offers treatment for substance use disorders in Quincy, Lowell, and Malden -- to resolve allegations that the company billed MassHealth for medically unnecessary urine drug tests.
In addition to paying $275,000 to MassHealth, Elm Tree is required to draft new policies and procedures that comply with MassHealth requirements. Elm Tree will also implement a three-year independent compliance monitoring program at its own expense. The compliance program will ensure compliance with MassHealth requirements and require annual audits, the results of which will be reported to the AGO.
MassHealth has promulgated specific regulations governing when providers may perform urine drug tests, including that they can only be performed when properly ordered, deemed medically necessary, and cannot be billed on the same date of service as a drug screen. Following a referral from MassHealth, the AGO’s investigation uncovered evidence that Elm Tree had performed drug tests that were not consistent with those requirements.
This case is representative of the AGO’s ongoing efforts to protect the integrity of services for members with opioid use disorder in the MassHealth program. In November 2025, the AGO announced a guilty plea with a Dracut physician who was charged with involuntary manslaughter associated with the illegal prescribing of opioids. In March 2025, the AGO obtained indictments against several MassHealth providers and their respective owners in connection with alleged fraud and kickback arrangements that collectively resulted in the submission of over $7.8 million in false claims to MassHealth, including for urine drug tests and home health services that were not provided, not medically necessary, and/or not properly authorized. In December 2024, the AGO secured a $2 million settlement with a behavioral health provider for billing MassHealth for more expensive office visits than provided and billing for medically unnecessary urine drug tests.
This matter was prosecuted by Assistant Attorney General Mary-Ellen Kennedy and Investigator Rachel Wiesler, both of the AGO’s Medicaid Fraud Division.
The AGO’s Medicaid Fraud Division is a Medicaid Fraud Control Unit, annually certified by the U.S. Department of Health and Human Services to investigate and prosecute health care providers who defraud the state’s Medicaid program, MassHealth. The Medicaid Fraud Division also has jurisdiction to investigate and prosecute complaints of abuse, neglect and financial exploitation of residents in long-term care facilities and of Medicaid patients in any health care setting. Individuals may file a Medicaid/MassHealth fraud complaint or report cases of abuse or neglect of Medicaid patients or long-term care residents by visiting the AGO’s website.
The Massachusetts Medicaid Fraud Division receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award totaling $6,458,176 for federal fiscal year 2026. The remaining 25 percent, totaling $2,152,724 for FY 2026, is funded by the Commonwealth of Massachusetts.
Media Contact
Kennedy Sims, Deputy Press Secretary
+
Phone
Call Kennedy Sims, Deputy Press Secretary at (617) 727-2543
Online
Email Kennedy Sims, Deputy Press Secretary at Kennedy.Sims@mass.gov
Office of the Attorney General
The Attorney General is the chief lawyer and law enforcement officer of the Commonwealth of Massachusetts.
Media Contact
Kennedy Sims, Deputy Press Secretary
Phone
Call Kennedy Sims, Deputy Press Secretary at (617) 727-2543
Online
Email Kennedy Sims, Deputy Press Secretary at Kennedy.Sims@mass.gov
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