Connecticut Addiction Medicine Provider Pays $1 Million to Settle Improper Billing Allegations
(STL.News) Leonard C Boyle, Acting United States Attorney for the District of Connecticut, and Connecticut Attorney General William Tong, today announced that CONNECTICUT ADDICTION MEDICINE, LLC, and its owners DR. JAY BENSON and DR. MAHBOOB ASLAM, have entered into a civil settlement agreement with the federal and state governments in which they will pay $1,002,481 to resolve allegations that they caused overpayments to be paid by the Medicare and Medicaid Programs.
Connecticut Addition Medicine (“CAM”) is a medical practice that provides behavioral health and addiction medicine services to Medicare and Medicaid beneficiaries at its offices located throughout Connecticut. Benson and Aslam are physicians and the principals of CAM.
The allegations against CAM arise out of improper billing for urine drug tests. Urine drug testing includes drug screening tests (also known as “presumptive” tests), which determine the presence or absence of a drug or metabolite in a patient’s urine, and confirmation tests (also known as “definitive” tests), which are more precise and provide a numerical concentration of a drug or metabolite in a patient’s urine. CAM regularly tested their patient’s urine in-house, using a presumptive test, but also sent the identical urine samples out to an independent reference laboratory to conduct more detailed definitive tests on each and every specimen. In many cases, CAM received the results of the definitive test from the independent lab in four days or less.
The government alleges that CAM, Benson and Aslam submitted claims for payment to Medicare and Medicaid for the in-office presumptive urine drug tests that the they knew, or should have known, were not medically necessary, because they also ordered and received, from the independent reference laboratory, the more detailed and reliable definitive urine drug test results on the identical urine samples, which were available to assess and treat their patients.
To resolve their liability, CAM, Benson and Aslam will pay $1,002,481 to the federal and state governments for conduct occurring between December 21, 2015, through August 31, 2017.
“Billing government health insurance programs for medically unnecessary testing diverts taxpayer money needed to pay for legitimate medical needs,” stated Acting U.S. Attorney Boyle. “The government will aggressively pursue health care providers who are overpaid by the Medicare and Medicaid programs for medically unnecessary tests.”
This matter was investigated by the Office of Inspector General for the Department of Health and Human Services. The case is being prosecuted by Assistant U.S. Attorney Richard M. Molot and by Assistant Attorneys Gregory O’Connell and Karla Turekian of the Connecticut Office of the Attorney General.