Medicaid Billing Scam Rocks Roanoke
ROANOKE, Va. – In a shocking turn of events, Virginia Treatment Center, LLC, doing business as Roanoke Comprehensive Treatment Center (RCTC) in Roanoke, has agreed to pay $348,934 to resolve allegations that it violated the False Claims Act by billing Medicaid for addiction treatment services that was not provided by the required licensed individuals.
The scandal, which spanned from January 1, 2018 through December 31, 2020, involved RCTC billing Virginia Medicaid for counseling services by people who were not credentialed as though the counseling had been provided by properly credentialed addiction professionals.
“At a time when addiction disorder is running rampant in many Virginia communities, we must continue to be vigilant in holding accountable those who seek to defraud Medicaid through fraudulent billing schemes like this one,” United States Attorney Christopher R. Kavanaugh said today.
“I’m glad that my office, in coordination with our partners in the Western District Attorney’s Office and Department of Health and Human Services, was able to reach a reasonable settlement with the Roanoke Comprehensive Treatment Center for allegedly billing Medicaid for addiction treatment services not provided by licensed officials. This is yet another example of the outstanding relationship between Virginia state and federal partners, and we’re continually grateful for their assistance,” said Attorney General Miyares
“Both insurers and patients can be misled when health care entities bill for services as if they were performed by individuals with certain credentials but, in reality, were furnished by less-qualified personnel,” stated Special Agent in Charge Maureen R. Dixon of the Department of Health and Human Services Office of Inspector General (HHS-OIG). “To protect the integrity of federal health care funds, HHS-OIG and our law enforcement partners remain insistent that providers charging programs such as Medicaid do so accurately and transparently.”
The allegations involved claims that RCTC was required to conduct face-to-face counselling sessions for its patients but instead billed Medicaid as though the counseling had been provided by credentialed addiction treatment professionals.
The resolutions obtained in this matter were the result of a coordinated effort between the U.S. Attorney’s Office for the Western District of Virginia, the U.S. Department of Health and Human Services, and the Virginia Attorney General’s Medicaid Fraud Control Unit.
Assistant U.S. Attorney Justin Lugar investigated the matter.
The claims resolved by the settlement are allegations only and there has been no determination of liability.
The defendant, Virginia Treatment Center, LLC, is a subsidiary of Acadia Healthcare that provides outpatient treatment, including medication-assisted treatment for adults suffering from opioid addiction.
Criminal charges: Violation of the False Claims Act by billing Medicaid for addiction treatment services that was not provided by the required licensed individuals.
City and state: Roanoke, Virginia
Exact date: January 1, 2018 through December 31, 2020
Sentence or outcome: $348,934 settlement
Dollar amount: $348,934
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Key Facts
- State: Virginia
- Category: Drug Trafficking|Fraud & Financial Crimes
- Source: DOJ Press Release â†â€â€
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