Psychological well being firm Well being Join America pays greater than $4.6 million “to resolve allegations that it billed Virginia Medicaid for providers not offered,” the U.S. Legal professional’s Workplace of Western District of Virginia introduced Friday.
Franklin, Tennessee-based Well being Join America gives psychological and behavioral well being providers to youth, people and households. It helps sufferers battling grief, anger administration, household points and substance use dysfunction. Well being Join America at present serves sufferers in Alabama, Georgia, Mississippi, Tennessee and Virginia.
Well being Join America allegedly improperly billed Medicaid for 3 totally different behavioral well being providers for kids, in line with the Legal professional’s Workplace. The primary is named Therapeutic Day Therapy, which is a school-based program for youths with a wide range of psychological well being situations. The psychological well being firm billed Virginia Medicaid for providers to college students who had been absent, in addition to throughout holidays and climate closures.
One other program it improperly billed Virginia Medicaid for is named Intensive In-home Companies, a home-based psychological well being program for kids who’re “prone to being faraway from their dwelling,” in line with the Legal professional’s Workplace. Nevertheless, Well being Join America allegedly billed Virginia Medicaid for providers by an worker who was engaged in a sexual relationship with a minor in Orange County, Virginia. The worker is at present serving a 10-year sentence.
Lastly, the corporate wrongly billed Virginia Medicaid for Behavioral Remedy Companies, a specialised psychological well being remedy for youths with situations like autism. Behavioral Remedy Companies are required to be offered by specially-trained psychological well being professionals. Nevertheless, Well being Join America billed for Behavioral Well being Companies by suppliers who weren’t “correctly skilled or credentialed” in Southwest Virginia.
The corporate additionally “used the title and Nationwide Supplier Identifier (NPI) variety of a properly-trained and credentialed psychological well being skilled positioned in Northern Virginia who had by no means seen purchasers in Southwest Virginia,” the Legal professional’s Workplace mentioned.
“Well being care suppliers have a accountability to submit correct and sincere claims to federal well being care applications to make sure that these assets can be found for eligible sufferers,” mentioned Maureen Dixon, particular agent in cost on the Division of Well being and Human Companies, Workplace of Inspector Normal (HHS-OIG), in a information launch. “HHS-OIG is dedicated to safeguarding precious taxpayer {dollars} and defending the integrity of the Medicaid program.”
Well being Join America has agreed to 5 years of further oversight and compliance. Compliance measures embody unannounced audits and extra reporting necessities if there are conditions of theft, fraud, abuse or neglect.
Not complying may result in “legal prosecution and contempt of courtroom proceedings that might end in further financial sanctions and injunctive aid,” the Legal professional’s Workplace acknowledged.
Well being Join America didn’t return a request for remark.
Picture credit score: Waldemarus, Getty Pictures
