Hamden Behavioral Health Provider Pays $234K In Settlement Agreement

HAMDEN, CT — A Hamden-based behavioral health provider and its owner paid more than $234,000 in a civil settlement agreement to resolve allegations that they violated the federal and state False Claims Acts, U.S. Attorney Vanessa Roberts Avery and Connecticut Attorney General William Tong announced.

Kelly Stutzman and her company K-Assist were accused of billing the Connecticut Medicaid Program for services provided by unlicensed individuals. In addition to the civil settlement, Stutzman has also been criminally prosecuted by the Medicaid Fraud Control Unit of the Connecticut Chief State’s Attorney’s Office, according to Tong.

“Kelly Stutzman and her company K-Assist repeatedly billed the Connecticut Medicaid program for thousands of hours of services she claimed to have provided but were instead provided by unlicensed individuals,” Tong said in a statement. “In addition to the civil settlement, she also pled nolo contendre to a criminal charge related to her participation in the Medicaid program. In conjunction with our state and federal partners, we will act aggressively to ensure our Medicaid dollars are used appropriately for the benefit of Connecticut patients.”

As part of the nolo contender plea, Stutzman agreed to pay $63,764 in restitution and be subject to a three-year suspended jail sentence and five-year conditional discharge, according to Avery.

K-Assist is a private behavioral health practice that provided in-home behavioral health services in the greater New Haven area. K-Assist is enrolled as a Behavioral Health Clinician Group and Stutzman is enrolled as a Professional Counselor in the Connecticut Medical Assistance Program, which includes the state’s Medicaid program, according to a news release.

Investigations were launched on the state and federal level after the Department of Social Services received a referral for allegations that K-Assist was knowingly billing the Connecticut Medicaid Program for services provided by unlicensed individuals.

“The investigations uncovered evidence of repeated billing for excessive services, including hundreds of dates where more than 12 hours of behavioral health services were allegedly provided by Stutzman in a single day,” officials wrote in a news release. “Through extensive interviews and document review, the investigation developed evidence that K-Assist routinely relied on unlicensed individuals to provide services, while billing the Connecticut Medicaid Program as though those services had been provided by licensed behavioral health clinicians. Behavioral health services provided by unlicensed individuals are not reimbursable through the Connecticut Medicaid Program.”

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.