CleanSlate Centers, which operates addiction treatment clinics across a number of states, has agreed to pay $4.5 million to Massachusetts’ Medicaid and Medicare programs over allegations it submitted fraudulent claims and performed unnecessary patient services beginning in the early 2010s.
The Massachusetts’ Attorney General’s (AG) Office and the U.S. Attorney’s Office (USAO) negotiated the settlement with CleanSlate on behalf of three of its brands – Total Wellness Centers, LLC, CleanSlate Centers, Inc., and CleanSlate Centers, LLC – which collectively make up CleanSlate Centers. Both the Massachusetts AG’s Office and USAO also negotiated the settlement with CleanSlate founder and former owner Dr. Amanda Louise Wilson.
The settlement pertained to lawsuits from the Massachusetts AG’s Office and a whistleblower alleging that CleanSlate violated the False Claims Act along with federal and state self-referral statutes.
The Massachusetts AG’s Office filed its lawsuit in October 2020, asserting that CleanSlate defrauded MassHealth – the state’s Medicaid program – by billing for urine drug tests given to patients, depending on their stage of treatment for substance use disorder (SUD). Some of those billed tests, according to the state AG’s Office, were medically unnecessary.
The AG’s Office also contended that CleanSlate – which was previously headquartered in Northampton, Massachusetts – directed its clinicians to refer its laboratory work to another lab it owned in the state, located in the town of Holyoke. That, according to the AG’s Office, was a violation of federal and state self-referral statutes given that Wilson owned both CleanSlate and the Holyoke lab.
Additionally, both CleanSlate and Wilson were alleged to have engaged in fraudulent billing by backdating prescriptions of buprenorphine, which is a medication-assisted treatment (MAT) drug used for opioid use disorder (OUD).
The backdating – according to the AG’s Office – occurred between 2011 and 2016. As part of the alleged backdating, patients using MassHealth were said to have picked up prescriptions sent to pharmacies by mid-level clinicians at CleanSlate after visits to the provider, rather than having buprenorphine prescribed by physicians.
After accessing patient records and reviewing patient visit notes, the physicians – who were employed part-time – were said to have signed the prescriptions retroactive to the patient visit dates.
The USAO previously alleged that CleanSlate engaged in the backdating practices from March 2012 to February 2014, which constituted a violation of the Controlled Substances Act. CleanSlate would resolve the allegations with the USAO in 2016.
The Massachusetts AG’s Office originally intervened in a whistleblower’s lawsuit – brought by a former CleanSlate employee – filed in 2017 in connection with the alleged backdating practices. A year earlier, Congress modified a law to allow nurse practitioners and physician assistants to prescribe buprenorphine. Previously, only physicians could prescribe the MAT drug.
CleanSlate told Behavioral Health Business in October 2020 that the Massachusetts AG’s claims against the provider were without merit and that it intended to fight the charges.
“We are disappointed with the Attorney General’s decision to intervene in this matter,” the provider told BHB at the time in an emailed statement. “We strongly believe this claim is without merit, and we look forward to the opportunity to demonstrate in court that the care provided to our patients was outstanding and the lab tests that were ordered were medically necessary.”
Under the terms of the settlement with the Massachusetts AG’s Office, CleanSlate and Wilson will pay a total of $3.2 million to MassHealth. Wilson, under agreement from the AG’s Office, also agreed to pay $8,000 to a regional SUD treatment organization.
CleanSlate and Wilson will additionally pay $1.3 million under the terms of an agreement with USAO to resolve all claims involving Massachusetts recipients of Medicare.
“As we face a worsening opioid crisis in Massachusetts, it’s important that treatment centers follow the rules and not cut corners to increase their bottom line,” Massachusetts Attorney General Maura Healey said in a statement released by the state AG’s Office. “Our resolution with CleanSlate will bring millions of dollars back to the state and implement the oversight needed to protect patients and prevent these violations from happening again.”
CleanSlate, which is now based in the Nashville suburb of Brentwood, Tennessee, operates centers across ten states.
The provider, whose board of directors includes former U.S. Rep. Patrick Kennedy, released a statement regarding the settlement where it denied any wrongdoing or illegal conduct.
“We have chosen to settle this case due to the severe economic impact a prolonged legal battle would have had on the thousands of individuals and families we serve,” CleanSlate CEO Greg Marotta said in the statement, which was published by the Associated Press and republished by other news outlets.
CleanSlate, as part of its agreement with the Massachusetts AG’s Office, will also be annually audited in an independent compliance program.