A Delaware operator of community clinics has agreed to pay more than $15 million to settle allegations of federal fraud related to mental health services and substance use disorder (SUD) treatment, the U.S. Department of Justice (DOJ) announced Thursday.
The settlement resolves two lawsuits against Connections Community Support Programs (CCSP) of WIlmington that were filed by the DOJ under the False Claims Act and the Controlled Substances Act. CCSP operated a number of clinics throughout Delaware before filing for bankruptcy in April, shortly after the DOJ brought their lawsuits.
CCSP has agreed to pay over $13.7 million plus interest to settle claims that it violated the False Claims Act. The act forbids providers from billing Medicare and Medicaid for mental health services performed by individuals whose professional credentials do not allow them to do so under federal insurance guidelines.
The DOJ asserted that not only did CCSP violate the False Claims Act by billing for mental health services performed by non-qualified professionals, but that it billed Medicaid for services using incorrect procedure codes for the individual who performed the service. As a result, the DOJ said CCSP received higher payments than it was legally allowed.
In regards to the Controlled Substances Act, CCSP is paying more than $1.6 million plus interest to resolve claims that it negligently failed to keep proper records of medication-assisted treatments (MATs) provided to patients for SUD.
The DOJ said that the MATs administered by CCSP — for which it allegedly failed to keep proper documentation of — included methadone and buprenorphine, which are commonly used in the treatment of opioid use disorder (OUD). Additionally, the DOJ said that the MATs were transferred between various CCSP locations without proper documentation.
The False Claims Act settlement partially resolves a whistleblower lawsuit that had previously been brought by two former CCSP employees against the provider. The lawsuit was brought under a provision of the False Claims Act and does not apply to separate claims the employees are continuing to pursue against former CCSP CEO Catherine Devaney McKay.
In addition, the government is continuing to pursue claims against McKay and two other CCSP executives — William Northey and Steven Davis — regarding violations of the Controlled Substances Act. Those claims are not part of the settlement agreement announced Thursday.
“For many years, Connections was improperly billing government programs for mental health services and failing to properly monitor and document its controlled substances inventory,” David Weiss, U.S. District Court attorney for the District of Delaware, said in a press release. “These settlements, together with the transfer of all of Connections’ services and operations to providers, finally resolve Connections’ long history of poor legal and regulatory compliance which jeopardized the provision of important mental health and substance abuse treatment to the residents of the State of Delaware.”
The settlement between CCSP and the government must still be approved by the U.S. Bankruptcy Court for the District of Delaware. The government, in its press release, acknowledged that the amount of money owed to CCSP creditors will be limited by what will be available in the bankruptcy estate.
CCSP’s assets and operations were sold in June to Conexio Care, Inc. and Coras Wellness and Behavioral Health, both of which provide mental health and SUD treatment services in locations throughout Delaware.