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Mental health provider pays $384k for overbilling Medicaid

A Connecticut-based mental health care provider has agreed to pay $384,322 in a civil settlement with the state and federal government. That settlement resolves an allegation that Community Mental Health Affiliates, Inc. (CMHA) overbilled the state’s Medicaid program for services.

The allegations stem from services provided at Harvest House in New Britain, one of CMHA’s 10 locations in the state. According to the U.S. Attorney’s Office, Harvest House is “a group home for clients with serious and persistent mental illness” and provides a Medicaid Rehabilitation Option (MRO) for clients. 

The MRO services are “designed to help clients who have functional disabilities secondary to serious and persistent mental illness achieve maximum functioning in self-care and independent living.”

To receive monthly MRO payments from the state program, the company has to provide at least 40 hours of services and properly document them.

According to the U.S. Attorney, the government argued that CMHA submitted claims for clients under the MRO program and were paid but did not properly document the 40 hours of services for them.

The $384k payment from CMHA is meant to cover a period from January 2015 through the end of 2019. The U.S. Attorney’s Office says the investigation of CMHA began due to a whistleblower complaint and that said whistleblower will receive 15% of the settlement, equal to $57,648.

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Tricia Ennis

An Emmy and AP award-winning journalist, Tricia has spent more than a decade working in digital and broadcast media. She has covered everything from government corruption to science and space to entertainment and is always looking for new and interesting stories to tell. She believes in the power of journalism to affect change and to change minds and wants to hear from you about the stories you think about being overlooked.

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