Norwalk Methadone Clinic Settles Overpayment Case With State: AG

NORWALK, CT — Connecticut Counseling Centers, which operates methadone clinics in Norwalk and other Connecticut locations, will pay the state and federal government $295,211 in a settlement involving overpayments for drug testing, according to Attorney General William Tong.

The state Department of Social Services provides clinics with a bundled payment for all services provided, including drug testing, according to Tong and United States Attorney John Durham and Social Services Commissioner Deidre S. Gifford.

A joint federal/state investigation found that between January 18, 2016 and December 31, 2016, CCC used an independent laboratory that separately billed the Connecticut Medical Assistance Program for urine drug testing, which resulted in double bills for testing. CCC was receiving its bundled payment, and the lab was filing separate bills with the state.

"CCC understood that their reimbursement from the CMAP included drug testing," said Tong in a statement. "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."

Added Gifford, "Drug testing is an integral part of the treatment process and bundled payments are intended to help providers focus on the delivery of that treatment. This case of double billing does not represent Medicaid-enrolled providers as a whole, but shows why we need strong and continuous enforcement of claiming standards on behalf of enrollees and taxpayers. I join Attorney General Tong in commending our federal and state partners in the investigation and settlement of this matter."

This is from Tong's announcement:

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.