Cheshire Social Worker Pays $145K In False Claims Settlement

CHESHIRE, CT — A Cheshire social worker will pay more than $145,000 to resolve allegations that she violated the federal and state false claims acts, according to authorities. Patricia McAlinden, a licensed clinical social worker who owns a private psychology practice in Cheshire, entered into a civil settlement agreement with the federal and state governments to settle the allegations, U.S. States Attorney for Connecticut John H. Durham announced.

McAlinden is enrolled as a Licensed Behavioral Health Clinician in Independent Practice in the Connecticut Medical Assistance Program (“CMAP”), which includes the state’s Medicaid program, according to officials.

“It is alleged that McAlinden billed Medicaid for psychotherapy services as if she had provided those services when in fact unlicensed individuals provided the services,” according to a news release from the U.S. States Attorney’s Office. “The Connecticut Department of Social Services Provider Manual for Licensed Behavioral Health Clinicians in Independent Practice explicitly states, ‘The department shall not pay for…services provided by anyone other than the provider.’”

To resolve the allegations under the federal and state False Claims Acts, McAlinden will pay $145,855.40 in order to reimburse the Medicaid program for conduct occurring from January 2016 to September 5, 2017. McAlinden has also agreed to a voluntary three-year suspension from the Connecticut Medicaid Program as part of the settlement, officials said.

Under the False Claims Act, the government can recover up to three times its actual damages, plus penalties of $11,181 to $22,363 for each false claim.

“Providers must bill Medicaid and other insurance programs accurately,” Durham said in a statement. “The U.S. Attorney’s Office will continue to work with our federal and state partners to protect the integrity of the Medicaid program and ensure its recipients receive the healthcare services they need.”

The case is part of a larger investigation into fraudulent activity in the area of behavioral health services, which has been jointly conducted by the Office of the Inspector General of the U.S. Department of Health and Human Services, the Medicaid Fraud Control Unit of the Chief State’s Attorney’s Office and the Connecticut Office of the Attorney General, with support from the Connecticut Department of Social Services, according to authorities.

People who suspect health care fraud are encouraged to report it by calling 1-800-HHS-TIPS or the Health Care Fraud Task Force at (203) 777-6311.