Connecticut Behavioral Health Clinician Group Pays $100K to Settle False Claims Allegations
(STL.News) John H. Durham, United States Attorney for the District of Connecticut, today announced that NEIL QUATRANO, and his business, BEHAVIORAL MANAGEMENT, LLC, have entered into a civil settlement agreement with the federal and state governments and will pay more than $100,000 to resolve allegations that they violated the federal and state False Claims Acts.
Behavioral Management is a private behavioral health practice located in North Haven, that provided after school and school break programs for children with behavioral and mental health issues. Behavioral Management is enrolled as both a Behavioral Health Clinician Group and a Professional Counselor Group in the Connecticut Medical Assistance Program (“CMAP”), which includes the state’s Medicaid program. Quatrano has a bachelor’s degree in social work, but he is not a licensed behavioral health provider in Connecticut.
It is alleged that Quatrano and Behavioral Management submitted fraudulent claims to Medicaid under CPT code 90876 for participants of the after-school and school-break program. CPT code 90876 requires “individual psychophysiological therapy incorporating biofeedback training by any modality (face-to-face with patient), with psychotherapy (e.g., insight oriented, behavior modifying or supported psychotherapy); 45 minutes.” Quatrano and Behavioral Management falsely represented that a licensed provider had rendered the services when, in fact, an unlicensed individual rendered the services. Quatrano and Behavioral Management also falsely represented that 45 minutes of one-on-one psychotherapy services were provided when in fact 20 minutes of group services were provided. Finally, Quatrano and Behavioral Management falsely represented that the services provided included biofeedback when, in fact, they did not.
To resolve the allegations under the federal and state False Claims Acts, Quatrano and Behavioral Management LLC have agreed to pay $100,842.86 in order to reimburse the Medicaid program for conduct occurring from January 1, 2014 through December 31, 2014.
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.
This case stems from a larger investigation into fraudulent activity in the area of behavioral health services, which has been jointly conducted by the Office of the Inspector General of the U.S. Department of Health and Human Services, 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.
This case was handled by Assistant U.S. Attorney Anne Thidemann, and Assistant Attorney General Joshua L. Jackson of the Connecticut Office of the Attorney General.
People who suspect health care fraud are encouraged to report it by calling 1-800-HHS-TIPS or the Health Care Fraud Task Force at (203) 777-6311.