State Files False Claims Act Lawsuit against East Hartford Behavioral Health Provider
The state has filed a lawsuit against an East Hartford-based licensed clinical social worker and her company alleging that they billed the state's Medicaid program for services that were not provided to Medicaid recipients, in violation of the Connecticut False Claims Act, Attorney General George Jepsen and state Department of Social Services (DSS) Commissioner Roderick L. Bremby said today.
The state alleges that Selina Christian, a resident of Palmer, Mass., and her company, The Center of Attention LLC, engaged in a systematic and persistent pattern of submitting claims for payment through the Connecticut Medical Assistance Program (CMAP) for psychotherapy services that were never actually provided to her CMAP patients.
"We take very seriously our responsibility to safeguard taxpayers by eliminating fraud in our taxpayer-funded healthcare programs," said Attorney General Jepsen. "In this case, we believe our investigation has uncovered a deliberate and sustained scheme to defraud Connecticut's Medicaid program by falsely billing for services that were never even provided to patients. My office and our law enforcement partners are committed to protecting the CMAP and vigorously pursuing all those who knowingly submit false claims."
"False claims are an affront to the Medicaid program and the taxpayers who fund it," said DSS Commissioner Bremby. "While this case does not represent our dedicated and responsible Medicaid providers overall, it is important to highlight as an example of why strong anti-fraud enforcement is necessary. We are proud of our work with the Attorney General's Office and law enforcement partners in this and similar actions on behalf of Medicaid program integrity."
From approximately January 2013 through at least December 2017, Christian and Center of Attention billed DSS, and received payments of more than $1,840,000, for psychotherapy services that were allegedly rendered to CMAP patients. The state alleges that Christian and Center of Attention routinely billed DSS for having provided 38 to 52 minutes of individual psychotherapy that was never provided to her CMAP patients. In addition, Christian and Center of Attention submitted claims to the CMAP for services that were not even reimbursable through CMAP, such as transportation, tutoring, and activities like "Pajama Jam" – a group where children would play games, watch movies and eat pizza.
The state also alleges that Christian and Center of Attention billed the CMAP for hundreds of hours of psychotherapy services that were never actually provided, citing several specific examples of CMAP patients who never received the individual psychotherapy services that were billed. The state further alleges that Christian and Center of Attention kept improper records and attempted to alter and falsify records after receiving a subpoena from the state in an effort to conceal the scheme.
The state's lawsuit seeks civil penalties and treble damages for the alleged Connecticut False Claims Act violations.
Attorney General Jepsen and Commissioner Bremby thanked the state's Medicaid Fraud Control Unit (MFCU) in the Office of the Chief State's Attorney for their partnership and assistance in investigating this case. This investigation was initiated by a fraud referral from the DSS Office of Quality Assurance's Special Investigations Unit.
Today's action is part of a larger effort by the State of Connecticut's Interagency Fraud Task Force, which was created in July 2013 to wage a coordinated and proactive effort to investigate and prosecute healthcare fraud directed at state healthcare and human service programs. The task force includes a number of Connecticut agencies and works with federal counterparts in the U. S. Attorney's Office and the U.S. Health and Human Services, Office of Inspector General – Office of Investigations. For more information, please visit www.fightfraud.ct.gov.
Anyone with knowledge of suspected fraud or abuse in the public healthcare system is asked to contact the Attorney General’s Antitrust and Government Program Fraud Department at 860-808-5040 or by email at firstname.lastname@example.org; the MFCU at 860-258-5986 or by email at email@example.com; or the Department of Social Services fraud reporting hotline at 1-800-842-2155, online at www.ct.gov/dss/reportingfraud, or by email to firstname.lastname@example.org.
Forensic Fraud Examiner Lawrence Marini and Assistant Attorneys General Joshua Jackson and Michael Cole, chief of the Antitrust and Government Program Fraud Department, are assisting the Attorney General with this matter.
Please click here to view the state's complaint.
Office of the Attorney General:
Jaclyn M. Severance
Department of Social Services: