Provider Fraud

September 7, 2017

Connecticut substance abuse treatment provider the Hartford Dispensary and the Hartford Dispensary Endowment Corporation and its former CEO Paul McLaughlin agreed to pay $627,000 to resolve allegations they violated the False Claims Acts by falsely representing and certifying to federal and state authorities that Hartford Dispensary had a medical director, as defined by relevant regulations, who was performing the duties and responsibilities required by federal and state law.  The allegations originated in a whistleblower lawsuit filed by former Hartford Dispensary employees Russell Buchner and Charles Hatheway under the qui tam provisions of the False Claims Act.  They will receive a whistleblower award of roughly $113,000 from the proceeds of the government's recovery.  DOJ (DCT)

September 5, 2017

National dental chain Dental Dreams, LLC agreed to pay $1.375 million to resolve allegations it improperly billed the Massachusetts Medicaid program for unnecessary and unjustifiable dental procedures.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by Dental Dreams former employee.  The whistleblower will receive an award from the proceeds of the government's recovery.  DOJ (DMA)

August 28, 2017

Oklahoma physician Dr. Gordon P. Laird agreed to pay $580,000 to settle allegations he violated the False Claims Act by submitting false claims to Medicare for services he did not provide or properly supervise.  He is a former owner and employee of the companies Blackwell Feet Plus, LLC, and Feet Plus, LLC, which later did business as Prevention Plus. DOJ (WDOK)

August 24, 2017

Nashville-based transportation service provider Employment & Assessment Solutions, Inc. and its principal Chris Manus agreed to pay $550,000 to settle allegations they violated the False Claims Act by submitting false claims to TennCare for transportation services which were never provided, including claims for patients who were actually incarcerated or hospitalized at the time of the purported transport. DOJ (MDTN)

August 3, 2017

The Medical Center of Central Georgia, Inc. (d/b/a The Medical Center, Navicent Health) agreed to pay roughly $2.6 million to resolve allegations it violated the False Claims Act by submitting bills for ambulance transports that were either inflated or medically unnecessary.  The allegations originated in a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by former Navicent paramedic Andre Valentine.  He will receive a yet-to-be-determined whistleblower award from the proceeds of the government's recovery.  DOJ (MDGA)

October 16, 2017

Louisiana announced the arrests of three New Orleans women as a result of an investigation exposing over $2 million in Medicaid Fraud. Lanice Stamps, 44 of New Orleans and owner of A New Direction Support Services, was arrested on 10 counts of Medicaid fraud for allegedly providing false and fraudulent claims for behavioral health services not rendered. Many recipients were fraudulently diagnosed as moderately mentally retarded or severely autistic so that the claims submitted could be billed at a higher level and they had never received counseling services. LA

September 7, 2017

The Hartford Dispensary will pay $627,000 through a federal-state settlement to resolve allegations that it violated the False Claims Act by falsely certifying to federal and state officials that it had a current medical director that was performing his duties in accordance with federal and state law. In 2014, the Office of the Attorney General commenced an investigation after a whistleblower complaint about the Hartford Dispensary, a private nonprofit behavioral health organization; the investigation was followed by a qui tam lawsuit alleging various violations of the state and federal False Claims Act. The state’s investigation focused on services that Hartford Dispensary provides as an opioid treatment program – primarily methadone and detoxification services.