BEHAVIORAL HEALTH AND SUBSTANCE ABUSE TREATMENT
DA TE
ENTITY
FCA ALLEGATIONS
AMOUNT
Behavioral health practice and its owner agreed to pay more than $100,000 to resolve FCA allegations that they improperly: (1) billed Medicaid for services provided by unlicensed individuals; (2) billed for one-on-one sessions when group sessions were actually provided; and (3) billed claims that falsely represented that biofeedback was provided when it was not. 72 Healthcare company, two of its hospitals and an affiliated substance abuse treatment facility agreed to pay $10.25 million to resolve FCA allegations that they provided free long-distance van transportation to patients to induce them to use their facilities, in violation of the AKS. The settlement also resolves allegations that the company and two hospitals submitted or caused the submission of claims to Medicare for medically unnecessary inpatient psychiatric admissions and associated services. As part of the resolution, Oglethorpe entered a five- year CIA with HHS-OIG. 73 In-home family therapy and counseling provider and its owners agreed to pay $273,000 to resolve FCA allegations that they improperly billed Medicaid for services provided by unlicensed individuals. 74 Behavioral health and addiction medicine practice and its two owners agreed to pay more than $1 million to resolve FCA allegations that they submitted claims to Medicare and Medicaid for medically unnecessary urine drug tests. 75 Substance abuse and mental health services provider agreed to pay more than $170,000 to resolve self-disclosed FCA allegations that it submitted claims to federal healthcare programs for services provided by an employee who was excluded from participating in federal healthcare programs. 76 Psychotherapy services provider and its CEO agreed to pay $2 million to resolve FCA allegations that they billed Medicare and Medicaid for psychotherapy services provided at nursing homes and SNFs that were medically unnecessary, improperly documented or upcoded to reflect services performed at higher intensity levels than justified. 77
Behavioral Management, LLC; Neil Quatrano
2/1/2021
$100,843
Oglethorpe Inc.; Cambridge Behavioral Hospital; Ridgeview Behavioral Hospital; The Woods at Parkside
3/5/2021
$10.25 million
Today's Youth LLC; Maurice Stuckey; Joyce Anderson
$273,000
4/6/2021
Connecticut Addiction Medicine, LLC; Dr. Jay Benson; Dr. Mahboob Aslam
$1.002 million
6/25/2021
Health Care & Rehabilitation Services of Southeastern Vermont
6/29/2021
$170,038
Carenow Services, LLC; Leena Karun
$2 million
8/25/2021
72 https://www.justice.gov/usao-ct/pr/connecticut-behavioral-health-clinician-group-pays-100k-settle-false-claims-allegations. 73 https://www.justice.gov/opa/pr/ohio-treatment-facilities-and-corporate-parent-agree-pay-1025-million-resolve-false-claims. 74 https://www.justice.gov/usao-ct/pr/behavioral-health-provider-pays-273k-settle-improper-billing-allegations. 75 https://www.justice.gov/usao-ct/pr/connecticut-addiction-medicine-provider-pays-1-million-settle-improper-billing. 76 https://www.justice.gov/usao-vt/pr/united-states-attorney-s-office-resolves-false-claims-act-investigation-improper. 77 https://www.justice.gov/usao-ndga/pr/georgia-psychotherapy-services-provider-pay-2-million-resolve-false-claims-allegations.
NOTABLE SETTLEMENTS BASS, BERRY & SIMS | 60
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