State Reaches False Claims Act Settlement with Norwich Behavioral Health Practice
A Norwich behavioral health practice and its co-owners, a mother and her daughter who are both licensed behavioral health clinicians, have agreed to a $300,000 settlement to resolve alleged violations of Connecticut's False Claims Act, Attorney General George Jepsen and state Department of Social Services (DSS) Commissioner Roderick L. Bremby said today.
Affinity Behavioral Health LLC ("Affinity") is co-owned by Julie Longton, a licensed marital and family therapist, and her daughter, Leanda Zupka, a licensed clinical social worker. Affinity, Longton and Zupka are enrolled as behavioral health providers in the Connecticut Medical Assistance Program (CMAP), which includes the state's Medicaid program.
The state alleged that, from April 2013 to December 2016, Affinity, Longton and Zupka knowingly submitted claims to the CMAP for payment for behavioral health services purportedly performed by licensed behavioral health clinicians when, in fact, the services were rendered by unlicensed individuals employed by Longton and Zupka.
"We take very seriously allegations of fraud and abuse in our taxpayer-funded healthcare programs," said Attorney General Jepsen. "Behavioral health services are a critical health care benefit for those who need such counseling and our Medicaid beneficiaries should be confident that their care will be rendered by qualified, licensed providers. My office will continue to partner with DSS and other law enforcement agencies to investigate and prosecute those who knowingly submit false claims."
"This is the latest in a series of False Claims Act cases that demonstrate the need for continual oversight to identify and address fraud allegations," said Commissioner Bremby. "I again join Attorney General Jepsen in commending the dedicated staff in state and federal agencies involved in safeguarding the integrity of our public health coverage programs."
The state's investigation in this case was initiated by a fraud referral from the DSS Office of Quality Assurance’s Special Investigations Unit. The $300,000 in settlement funds will be returned to the state's Medicaid program.
The Settlement Agreement also requires Affinity, Longton and Zupka to implement a five-year compliance program that includes written policies, procedures and standards of conduct,a designated compliance officer, training and education; auditing, and corrective action plans, in order to prevent and detect fraud, waste and abuse occurring in the CMAP.
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 he 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 Medicaid Fraud Control Unit 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.
Assistant Attorney General Karla Turekian, Legal Investigator Thomas Martin and Assistant Attorney General Michael Cole, chief of the Antitrust and Government Program Fraud Department, assisted the Attorney General with this matter.
Please click here to view the settlement document.
Office of the Attorney General:
Jaclyn M. Severance
Department of Social Services: