A Connecticut private behavioral health practice and its owner have agreed to pay more than $100,000 to settle state and federal fraud allegations, the U.S. Department of Justice (DOJ) announced Monday.
Behavioral Management LLC of North Haven and its owner, Neil Quatrano, have entered into a civil settlement agreement following allegations that the company submitted fraudulent claims for Medicaid services in violation of the federal False Claims Act. The alleged fraud occurred between January 1, 2014 and December 31, 2014, according to the DOJ.
Behavioral Management had previously operated after-school and school break programs for children with mental and behavioral health issues, and it was enrolled as both a behavioral health clinician group and as a professional counselor group in the Connecticut Medical Assistance Program (CMAP), which offers a comprehensive health care benefit package that supports Medicaid and the Children’s Health Insurance Program (CHIP).
The problem, according to the DOJ, is that Quatrano is not a licensed behavioral health provider as he represented in his Medicaid claims. Instead, he only had a bachelor’s degree in social work, meaning the services that he and Behavioral Management rendered were delivered by an unlicensed individual.
The DOJ also said that Quatrano and Behavioral Management billed for one-on-one psychotherapy services lasting 45 minutes, when only 20 minutes of group therapy services had been provided. Finally, the company and its owner were accused of falsely claiming they provided biofeedback when they did not.
Had Quatrano and Behavioral Management not settled, they could have ended up facing a heftier fine in the long run. Under the False Claims Act, the government can recover up to three times its actual damages, plus penalties of $11,665 to $23,331 for each false claim.
The case stems from a larger investigation into behavioral health fraud, which has been jointly conducted by the Office of the Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS), the Medicaid Fraud Control Unit of the Chief State’s Attorney’s Office and the Connecticut Office of the Attorney General, with support from the Connecticut Department of Social Services.
“Neil Quatrano and Behavioral Management allegedly submitted fraudulent Medicaid claims for therapy and services that were never provided,” Connecticut Attorney General William Tong said in a press release. “In conjunction with our federal and state partners, the Office of the Attorney General will take strong action against anyone who misuses our state’s Medicaid program to the detriment of both taxpayers and patients.”