In our last blog, we revisited the unfortunate opioid epidemic facing our nation. The post highlighted a recent conviction of an Alabama-based doctor who pleaded guilty to distributing oxycodone. The highly addictive opioid is known for causing overdoses and death. Due to health practitioners who value profit over patient care, the opioid crisis rages on. This week, we examine the case of an opioid abuse treatment facility in New Jersey accused of kickback violations.
As reported by the District of New Jersey branch of the United States Department of Justice last week, Camden Treatment Associates LLC (CTA) will pay a total of $3.15 million. The payment is to resolve criminal and civil claims that it caused kickbacks, obstructed a federal audit and fraudulently billed Medicaid.
CTA is alleged to have violated the federal Anti-Kickback Statute.
The treatment facility is also accused of obstructing a Medicaid audit. To resolve the allegations, CTA agreed to pay $1.5 million in criminal penalties. On December 2nd, CTA was officially charted with the misconduct in a Camden federal court. The treatment facility entered into a three-year deferred prosecution agreement (DPA) that requires it to abide by certain measures to avoid conviction.
“CTA also entered into a civil settlement agreement to pay $1.65 million to the United States to resolve claims that it violated the federal False Claims Act by submitting fraudulent claims to Medicaid,” reports the DoJ.
CTA had a kickback relationship with another company.
Between 2009 and 2015, CTA ordered all of its methadone mixing services from a second company. It paid more than $125,300 for those services. The arrangement resulted in kickbacks being paid. “The second company paid the profits it made on CTA’s orders of methadone mixing to the related parties who owned and managed both companies,” says the DoJ report, “As a result, CTA was induced to order services from the second company and to have CTA patients receive treatment using methadone mixed only by that company. CTA received more than $2.78 million from Medicaid for methadone administration services.”
CTA was also involved in a separate criminal scheme. In it, the treatment facility obstructed a Medicaid contractor’s 2016 audit of CTA’s claims for payment. The company submitted falsified materials to the auditor purporting to justify its claims to Medicaid.
CTA added patient and counselor signatures to patient files.
They also altered names of counselors listed as providing services. As well, CTA added credentials for staff listed as performing services, added sign-off dates for services and, in some cases, submitted entire patient notes to files to justify services rendered. “Metadata from CTA’s electronic patient software program revealed that CTA employed these fraudulent means,” the DoJ details.
The $3.15 million settlement resolves the civil allegations that CTA submitted false claims to Medicaid stemming from the kickback relationship with the methadone mixing company. It also resolves allegations that between 2013 and 2016, CTA failed to comply with certain federal and state regulations governing substance abuse treatment facilities.
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