Recovery Network Of Programs Settles On Drug Testing Overbilling

Press release from the office of the Attorney General of Connecticut:

July 24, 2020

Attorney General William Tong, U.S. Attorney John H. Durham, and Department of Social Services Commissioner Deidre S. Gifford today announced a $354,368 joint federal/state settlement with the Recovery Network of Programs (RNP) resolving overbilling for drug testing.

RNP operates methadone clinics in the Bridgeport area. The Department of Social Services provides clinics with a bundled payment for all services provided, including drug testing. A joint federal/state investigation found that between June 2016 and October 2017, RNP used an independent laboratory that separately billed the Connecticut Medical Assistance Program (CMAP) for urine drug testing. This resulted in double bills for testing through the bundled payments to RNP and the separate charge by the independent laboratory.

“RNP understood that their reimbursement from the CMAP included drug testing. By outsourcing this work, they in effect caused the CMAP to pay twice for the same service. Jointly with our federal and state partners, the Office of the Attorney General will take aggressive action to protect our publicly funded healthcare programs,” said Attorney General Tong.

“Drug testing is an important part of the treatment process and bundled payments are intended to help providers with the delivery of that treatment. This case of double billing and the resulting settlement again demonstrates the need for strong enforcement of claiming standards on behalf of enrollees and taxpayers. I join Attorney General Tong in commending our DSS anti-fraud investigators and our state and federal partners in the resolution of this matter,” said Commissioner Gifford.

Attorney General Tong thanked the U.S. Health and Human Services Office of the Inspector General/Office of Investigations, the Office of the United States Attorney, and the DSS Office of Quality Assurance for their coordination in this case.

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 ag.fraud@ct.gov; the Medicaid Fraud Control Unit at 860-258-5986 or by email at conndcj@ct.gov; 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 providerfraud.dss@ct.gov.

Assistant Attorneys General Gregory K. O'Connell and Michael E. Cole, Chief of the Antitrust and Government Program Fraud Department and Legal Investigator Lisa Bailey assisted the Attorney General in this matter.

This press release was produced by the Attorney General of Connecticut. The views expressed here are the author's own.