Harvard Vanguard Medical Associates
Outcome
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Details
Harvard Vanguard Medical Associates — $168,000 Fine
Outcome: Official websites use .gov A .gov website belongs to an official government organization in the United States.
Official websites use .gov A .gov website belongs to an official government organization in the United States.
Secure .gov websites use HTTPS A lock ( Lock A locked padlock ) or https:// means you’ve safely connected to the .gov website. Share sensitive information only on official, secure websites.
After it self-disclosed conduct to OIG, Harvard Vanguard Medical Associates, Inc. (HVMA), Massachusetts, agreed to pay $168,687 for allegedly violating the Civil Monetary Penalties Law. OIG alleged that HVMA submitted claims to Medicare, Medicare's Atrius Health Pioneer Accountable Care Organization, and Massachusetts Medicaid using CPT codes 90805 and 90807 for services provided by a physician when the services rendered by the physician did not meet the coverage requirements for CPT codes 90805 and 90807.
HHS Office of Inspector General
How Crucible Prevents This
Crucible's compliance monitoring controls for Behavioral Health / SUD Treatment would have detected the patterns underlying this violation through automated screening, documentation enforcement, and real-time alert escalation.
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