RegalCare Management Group Settled Billing Allegations
The healthcare provider agreed to pay $1 million to resolve claims of unnecessary services submitted to government programs.
Updated on Sept. 23, 2026 in Healthcare
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RegalCare Management Group and two executives settled allegations that they submitted medically unreasonable claims to Medicare and Massachusetts Medicaid. The company paid $1 million to resolve the False Claims Act complaint.
Why it matters
The settlement addresses systemic efforts to inflate therapy service claims for financial gain. This resolution helps recoup funds lost through unauthorized billing practices that targeted public health programs.
The defendants reached a $1 million settlement regarding allegations of therapy overbilling. The case involves a $165,000 payout to the whistleblower who brought the complaint forward.
The players
RegalCare Management Group
This is a healthcare management firm that operated facilities in Massachusetts and Connecticut.
Hector Caraballo
He is an executive accused of modifying patient records without authorization.
Eliyahu Mirlis
He is an executive alleged to have directed the submission of premature billing claims.
Stern Therapy
This company reached a separate federal settlement regarding conspiracy to commit overbilling in March 2026.
The details
Between 2018 and 2023, RegalCare submitted claims for therapy services that lacked clinical authorization or patient need. Executive Hector Caraballo was accused of modifying records, while Eliyahu Mirlis directed staff to submit billings before required assessment forms were finalized.
Timeline
The improper claims were submitted between 2018 and 2023.
A False Claims Act complaint was filed in February 2025.
The United States settled a related overbilling case with Stern Therapy in March 2026.
The RegalCare settlement was announced on September 22, 2026.
Market Landscape
This settlement follows the standard federal enforcement patterns established by the False Claims Act. It highlights the ongoing regulatory oversight of therapy service providers operating across the region.
Patients and their families are often the unintended targets of billing fraud when clinical records are modified without consultation. This case underscores the importance of verifying that services documented in a medical file accurately reflect the care actually delivered.
The takeaway
Healthcare providers face significant legal and financial consequences for inflating billing claims for therapy services. Patients should regularly review their medical and billing records to ensure that all documented treatments align with the care they received.
Further reading
Learn more about local industry oversight on our Healthcare page.
Source note: This article includes information reported by The United States Department of Justice.
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