A Hartford, Connecticut-based behavioral health care practice and its owners have agreed to a civil settlement with federal and state governments to settle allegations they improperly billed Medicaid.
The U.S. Department of Justice (DOJ) announced Tuesday that Maurice Stuckey and Joyce Anderson, as well as their company Today’s Youth LLC, will pay $273,000 to resolve the allegations of conduct the DOJ says occurred between January 1, 2014 and September 1, 2019.
Today’s Youth provides therapy and counseling for children and families in the greater Hartford area, with services being rendered in-home. The organization is enrolled as a behavioral health clinical provider in the Connecticut Medical Assistance Program (CMAP), which includes the state’s Medicaid program.
The government claims that, while contracted with the state, Today’s Youth routinely submitted claims to Medicaid for behavioral health services as if they were performed by a licensed clinician, when they were actually performed by unlicensed individuals.
That’s a problem because the Connecticut Department of Social Services, the state agency Today’s Youth was contracted with, prohibits independent practices to submit claims for services provided by unlicensed individuals, even if the individuals are working toward licensure and are supervised by a licensed individual. As such, the U.S. and the state should have not paid those claims.
“Services performed by unlicensed providers expose Medicaid patients to substandard care and undermine the integrity of our healthcare system,” Connecticut Attorney General WIlliam Tong said in a statement regarding the settlement. “When providers fail to abide by their obligations in their provider contract with them, we stand ready with our state and federal partners to hold them accountable.”
The settlement comes two months after the DOJ and the Connecticut Attorney General’s Office reached an agreement in a separate improper billing case involving a youth behavioral health services practice.
In February, federal and state authorities reached a settlement with Neil Quatrano, the owner of North Haven-based Behavioral Management LLC, over charges of fraudulent Medicaid billing that they say occurred between January 1, 2014 and December 31, 2014.
Behavioral Management had previously operated after-school and school break programs for children with mental and behavioral health issues, and, like Today’s Youth, it was enrolled in CMAP.
The DOJ accused Quatrano of billing for Medicaid services under the guise that he was a licensed behavioral health clinician, when, in fact, he only had a bachelor’s degree in social work and was not considered to be licensed, in addition to other allegations.
Quatrano ultimately agreed to pay more than $100,000 to settle the case.