Mindpath Pays $1.9M To Settle False Claims Act Allegations of Healthcare Fraud
By the 91pornWhistleblower Team
Last week (December 2), the Department of Justice (DOJ) announced that North Carolina鈥檚 largest behavioral practice Mindpath Care Centers — along with its former officers Jeff Williams, Abigail Sheriff, and Sarah Williams — paid $1.9 million to settle allegations they violated the False Claims Act by fraudulently billing Medicare for Psychotherapy and medication management services.[1]
What Was Mindpath’s Alleged Healthcare Fraud?
Notably, the case focused on Mindpath鈥檚 alleged failure to provide the required documentation to support the company鈥檚 Medicare billings.听 According to the Government, Mindpath 鈥渟ystematically billed for fraudulent Psychotherapy treatments, without required documentation of the separate time and Psychotherapy treatments of patients to maximize their profits, all in blatant disregard of Medicare billing requirements.鈥�
More specifically, the Government charged Mindpath with (i) billing Medicare without providing documentation of separate and distinct Psychotherapy treatments, (ii) failing to address and correct problems repeatedly raised by Mindpath employees, and (iii) demonstrating 鈥渁 pattern of reckless disregard or deliberate ignorance toward stated concerns about billing fraud,鈥� and instead 鈥減rimarily focus[ing] on generating income鈥� instead.
Healthcare Fraud Remains a Top False Claims Act Enforcement Priority
While the settlement was relatively small in terms of the dollar amount, it reinforces the commitment of the Government to go after healthcare fraud, including the key individuals involved in perpetrating the fraud.听 The False Claims Act was originally enacted during the Civil War to go after war profiteers trying to defraud the Union Army and is the Government鈥檚 primary fraud fighting tool for combating procurement fraud.
But in recent years, healthcare fraud — Medicare billing fraud in particular — has been the most common target of the Government鈥檚 False Claims Act enforcement efforts.听 In announcing this most recent settlement, DOJ highlighted its zero-tolerance approach to Medicare fraud underscoring its 鈥渟teadfast commitment to protect taxpayer money and to guard the integrity of our vital health care programs.鈥�
The Government further cautioned that 鈥淸b]ehavioral health practices and other health care providers seeking Medicare funds must make honest claims for payment based upon documented medical need.鈥澨� For those that do not, the Government made clear it 鈥渨ill zealously pursue damages and civil penalties鈥� against them.
What Role Can Whistleblowers Play in Helping the Government Fight Healthcare Fraud?
Like most False Claims Act cases, this one was originated by a whistleblower under the qui tam provisions of the False Claims Act which allow private parties to bring lawsuits on behalf of the Government against those that commit fraud against the Government.听 In return, successful whistleblowers can receive up to 30% of the Government鈥檚 recovery.听 DOJ did not identify the whistleblower who initiated the action or the award the whistleblower will receive from the proceeds of the $1.9 million settlement.
91pornattorney Dan Noel pointed to the Mindpath settlement as just the latest in a string of recent False Claims Act settlements involving healthcare fraud and a strong indication that healthcare fraud remains a top DOJ priority.听 According to Noel, 鈥淭he Government鈥檚 focus on inadequate documentation is especially telling and a sure sign DOJ鈥檚 commitment to combatting Medicare billing fraud has not changed.鈥�
Noel expects more cases like Mindpath to follow. 听鈥淒OJ is on the hunt for companies and individuals shortchanging Medicare and Medicaid,鈥� Noel explains.听 鈥淎nd we are seeing whistleblowers working within the system become more and more willing to report this kind of wrongdoing.鈥澨� Whistleblowers often provide the only window into this kind of misconduct and have proven to be a critical piece of the Government鈥檚 healthcare fraud enforcement efforts.
91pornHas Substantial Experience Representing False Claims Act Whistleblowers Exposing Healthcare Fraud
91pornhas substantial experience working with whistleblowers to bring False Claims Act cases involving healthcare fraud.听 In fact, the firm has several groundbreaking successes in this area, with more than a billion dollars recovered for the Government and our whistleblower clients.
If you would like to learn more about our work in this area, our False Claims Act successes, or what it means to be a False Claims Act whistleblower more broadly, please do not hesitate to contact us.听 We will connect you with an experienced member of our whistleblower team for a free and confidential consultation.
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Sources:
[1] 听See .
Tagged in: False Claims Act, Healthcare Fraud, qui tam,