ATLANTA, GA – A Roswell-based psychotherapy services provider has agreed to pay $2 million to settle allegations that they billed Medicare and Medicaid for medically unnecessary, improperly documented, or upcoded psychotherapy sessions at nursing homes and skilled nursing facilities.
Carenow Services, LLC, and its CEO Leena Karun have agreed to pay $2 million to settle allegations that they violated the False Claims Act by billing Medicare and Medicaid for psychotherapy sessions at nursing homes and skilled nursing facilities that were medically unnecessary, improperly documented, or billed at higher intensity levels than justified.
The settlement resolves False Claims Act allegations that between 2012 and 2018, Carenow billed Medicare and Medicaid for psychotherapy sessions at nursing homes and skilled nursing facilities that did not have any documented medical necessity. Additionally, in those situations where the psychotherapy sessions were medically necessary, Carenow allegedly upcoded its services and billed Medicare and Medicaid at higher reimbursing procedural codes.
“Indiscriminately billing the government for psychotherapy services without regard to medical need or intensity of treatment deprives taxpayers of precious federal healthcare resources,” said Acting U.S. Attorney Kurt R. Erskine. “We remain committed to investigating healthcare fraud, particularly those schemes that target the most vulnerable in our communities. Those who commit healthcare fraud should know that they risk significant fines, penalties and even federal prison time.”
The investigation was conducted by the U.S. Attorney’s Office for the Northern District of Georgia, the Georgia Medicaid Fraud Control Unit, and Health and Human Services—Office of the Inspector General, and the Federal Bureau of Investigations.
The civil settlement was reached by Assistant U.S. Attorney Armen Adzhemyan, who is the civil Elder Justice Coordinator, and Georgia Assistant Attorney General Sara Vann. The claims resolved by this settlement are allegations only and there has been no determination of liability.
Defendant: Carenow Services, LLC
Criminal Charges: Violation of the False Claims Act
City and State: Roswell, Georgia
Date: Between 2012 and 2018
Sentence: $2 million settlement
Dollar Amount: $2 million
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Key Facts
- State: Georgia
- Category: Fraud & Financial Crimes
- Source: DOJ Press Release â†â€â€
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