Behavioral health provider Health Connect America agreed to pay $4.6 million to resolve allegations it billed Virginia Medicaid for services that were not provided.
The company agreed to be subject to five years of increased compliance, according to a July 7 Justice Department news release. Failure to comply with its obligations may result in criminal prosecution and contempt of court proceedings that could result in additional monetary sanctions and injunctive relief.
Health Connect America allegedly improperly billed Medicaid for three separate behavioral health services to children who qualify, according to the release:
- The company billed Medicaid for providing services to students who were absent from school and when school was not open due to holiday or weather closures.
- It billed Medicaid for intensive in-home services provided by an employee who was having a sexual relationship with a juvenile patient. That employee has since been prosecuted and is serving a 10-year sentence.
- It billed for services that were provided by individuals who were not properly trained or credentialed in Southwest Virginia, and used the name and National Provider Identifier number of a properly trained and credentialed mental health professional located in Northern Virginia who had never seen clients in Southwest Virginia.