Miguel Saravia, Healthcare Fraud, Massachusetts 2024
BOSTON – A scheme to defraud health care benefit programs by directing false billing for patient visits has landed a Massachusetts executive in hot water. Miguel Saravia, the Chief Executive Officer of Dana Group Associates and former Chief Operating Officer of Prime Behavioral Health, was sentenced to three and a half months in prison, to be followed by one year of supervised release.
Saravia, 42, of Hanson, was also ordered to pay $561,141.89 in restitution. The scheme, which ran from approximately 2017 to 2022, involved directing a group of individuals with no billing or medical training to enter Current Procedural Terminology codes (CPT) for therapy services that were not provided and to upcode CPT codes used for psychotherapy visits.
Saravia submitted, or directed the submission of, false claims for treatment that was not provided or for more complex and expensive treatment than was provided. The former executive pleaded guilty to six counts of health care fraud in September 2024.
United States Attorney Leah B. Foley, Roberto Coviello, Special Agent in Charge of the U.S. Department of Health and Human Services, Office of Inspector General, Jodi Cohen, Special Agent in Charge of the Federal Bureau of Investigation, Boston Division, Insurance Fraud Bureau Executive Director Anthony DiPaolo, and Thomas Demeo, Acting Special Agent in Charge of the Internal Revenue Service’s Criminal Investigations in Boston made the announcement today.
Assistant U.S. Attorneys Kelly B. Lawrence and Mackenzie A. Queenin of the Health Care Fraud Unit and Lindsey Ross and Steven Sharobem of the Affirmative Civil Enforcement Unit prosecuted the case.
Miguel Saravia is the defendant/respondent in this case. The exact criminal charges are six counts of health care fraud. The city and state involved are Boston, Massachusetts. The exact date of the sentencing is not specified but it is noted that Saravia pleaded guilty in September 2024. The sentence or outcome is three and a half months in prison, to be followed by one year of supervised release, and $561,141.89 in restitution.
According to the press release, the scheme involved directing a group of individuals to enter false CPT codes for therapy services and upcoding CPT codes for psychotherapy visits. This resulted in false claims for treatment that was not provided or for more complex and expensive treatment than was provided.
The case was prosecuted by Assistant U.S. Attorneys Kelly B. Lawrence and Mackenzie A. Queenin of the Health Care Fraud Unit and Lindsey Ross and Steven Sharobem of the Affirmative Civil Enforcement Unit.
Key Facts
- State: Massachusetts
- Category: White Collar Crime
- Source: DOJ Press Release â†â€â€
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