New Britain, Conn.-based Community Mental Health Affiliates has agreed to pay $384,322 to settle allegations that the behavioral health organization overbilled Medicaid for services, the U.S. Department of Justice said Feb. 2.
The organization allegedly submitted claims for Medicaid rehabilitation option services to the state's Medicaid program. To receive funding for the services, which are meant for patients who have a secondary disability in addition to severe and persistent mental illness to gain independence, facilities must provide at least 40 hours of MRO services per month with each eligible patient.
Investigators found that the organization submitted MRO claims for certain clients but did not document at least 40 hours of services per month for the clients between January 2015 to December 2019.
The investigation was initiated by the filing of a complaint under the whistleblower provisions of the federal and state False Claims Acts. The whistleblower will receive $57,648 of the settlement.