Behavioral Healthcare Company Executive Charged with Healthcare Fraud

BOSTON – The Chief Executive Officer of Dana Group Associates, who is also the former Chief Operating Officer of Prime Behavioral Health, was charged today in connection with a scheme to defraud health care benefit programs by directing false billing for patient visits.
 
Miguel Saravia, 42, was charged and has agreed to plead guilty to six counts of health care fraud. A plea hearing date has not been set.  
 
According to the charging documents, from approximately 2017 to 2022, Saravia directed 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. It is further alleged that 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 charge of health care fraud carries a sentence of up to 10 years in prison, up to three years of supervised release, and a fine of up to $250,000, or twice the gross gain or loss from the offense. Sentences are imposed by a federal district court judge based upon the U.S. Sentencing Guidelines and statutes which govern the determination of a sentence in a criminal case.

Acting U.S. Attorney Joshua S. Levy; 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 Harry Chavis, Jr., 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 are prosecuting the case.

The details contained in the charging document are allegations. The defendant is presumed innocent unless and until proven guilty beyond a reasonable doubt in a court of law.