Medicaid Investigators Recovered $98M Through Fraud and Abuse Cases from Behavioral Health Providers

The behavioral health industry saw $98.4 million in Medicaid funding clawed back through civil and criminal actions in federal fiscal 2021, according to a new report released by the Office of Inspector General (OIG) of the Health and Human Services Department. In total, Medicaid Fraud Control Units (MFCUs) recovered about $1.7 billion — $856.6 million […]

CleanSlate Centers to Pay $4.5 Million to Settle Billing Fraud Allegations

CleanSlate Centers, which operates addiction treatment clinics across a number of states, has agreed to pay $4.5 million to Massachusetts’ Medicaid and Medicare programs over allegations it submitted fraudulent claims and performed unnecessary patient services beginning in the early 2010s. The Massachusetts’ Attorney General’s (AG) Office and the U.S. Attorney’s Office (USAO) negotiated the settlement […]

Addiction Treatment Operators Convicted for Allegedly Orchestrating $112M Fraud Scheme

In an alleged scheme of massive proportions, two Florida brothers were convicted Thursday on federal charges of billing fraud at addiction treatment centers they operated. The ruling came from a South Florida jury after a seven-week trial, in which brothers Jonathan and Daniel Markovich were accused of fraudulently billing $112 million in services at two […]

Former Execs, PE Firm Settle Mental Health Fraud Case for $25 Million

Former executives of the South Bay Mental Health Center (SBMHC), headquartered in Massachusetts, and their private equity (PE) backers have settled a Medicaid fraud suit filed in 2018 by the Massachusetts Attorney General (AG) for a record $25 million. To date, this is the largest publicly disclosed government health care fraud settlement involving PE oversight […]

Former SUD Treatment Provider CEO Sentenced for $18M Claim Scheme

The former president and CEO of a California addiction treatment center was sentenced to 84 months in federal prison on charges of administering a fraudulent claim scheme, which cost the state more than $18.5 million. Richard Ciampa, of the Los Angeles suburb of Commerce, was also ordered to pay more than $17.6 million in restitution […]

Community Clinic Operator Pays $15M to Settle Fraud Allegations Over Mental Health, SUD Treatment Services

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 […]

Proposed Changes Would Make It Harder, More Expensive for Behavioral Defendants to Beat FCA Claims

As the behavioral health industry garners more national attention and funding, it’s also seeing more audits and repayment requests from payers. For example, in fiscal year (FY) 2020, the space saw a “marked uptick” in False Claims Act (FCA) settlements, according to Bass, Berry & Sims’ annual Healthcare Fraud & Abuse Review, which was released […]

Pair Plead Guilty to Multi-State SUD Kickback Scheme

Two former substance use disorder (SUD) treatment professionals have pleaded guilty to participating in a multi-state kickback scheme, according to the Department of Justice (DOJ).  The men — Michael Olshavsky, of Miami, and John Paul Linke, of Bristol, Tenn. — now face up to five years in prison each. Olshavsky and Linke conspired to pay […]

Father, Son Sentenced for Nationwide SUD Scam

In what is thought to be the first case of fraudulent enrollment of individuals under the Affordable Care Act (ACA), a Southern California father and son have been fined and sentenced to federal prison for falsely signing up individuals for drug treatment at rehab centers. Jeffrey White, 63, and his son, Nicholas White, 35, had […]