Connecticut officials announced a joint federal and state False Claims Act settlement with a behavioral health and drug counseling practice and its owners who allegedly cheated the state’s Medicaid program out of more than $1 million.
Connecticut Attorney General George Jepsen and state Department of Social Services (DSS) Commissioner Roderick L. Bremby said that New Era Rehabilitation Center and its co-founder owners Dr. Ebenezer Kolade and Dr. Christina Kolade have agreed to pay $1,378,533 to settle the False Claims Act allegations.
“Providers enrolled in Connecticut’s Medicaid program are required to play by the rules,” Attorney General Jepsen said in a statement. “In this case we alleged the providers billed for psychotherapy services that were not actually provided in addition to billing, in effect, twice for the same services. This conduct diverted taxpayer dollars earmarked to help fight the opioid epidemic that has plagued our state.
New Era maintains offices in New Haven and Bridgeport and provides methadone treatment services for patients struggling with opioid addiction. Most of New Era’s patients are beneficiaries of Connecticut’s Medicaid program, known as CMAP or the Connecticut Medical Assistance Program.
The state and federal governments said the False Claims Act violations occurred over a four-year period starting in October 2009.
The state and federal governments alleged that New Era and the Kolades billed CMAP weekly for a methadone bundled service rate that included various services not routinely provided, then submitted a separate claim for virtually every drug counseling session provided to clients by using a billing code for more expensive outpatient psychotherapy.
The state and federal governments further alleged that those psychotherapy sessions were actually the drug counseling sessions already included and reimbursed through the bundled rate.
The False Claims Act settlement returns $881,945 to CMAP. The remainder will be returned to the federal government, which subsidizes state Medicaid programs.