Norwich therapists settle false claims case with payment
A mother and daughter who co-own a behavioral health practice in Norwich have agreed to pay $300,000 to settle an allegation that they billed the state Medicaid program for services provided by unlicensed therapists.
State Attorney General George Jepsen and Department of Social Services Commissioner Roderick L. Bremby announced the settlement by Affinity Behavioral Health LLC in a joint news release Tuesday.
Julie Longton, a licensed marital and family therapist, and her daughter, Leanda Zupka, a licensed clinical social worker, are enrolled as providers in the Connecticut Medical Assistance Program, which includes the state's Medicaid program, according to the release.
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 (health care) programs," Jepsen said. "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."
The state's investigation 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 to prevent and detect fraud, waste and abuse occurring in the CMAP.
The investigation was conducted by the state's Interagency Fraud Task Force, which was created in July 2013 to investigate and prosecute fraud directed at state health care and human service programs. The task force includes a number of state agencies and works with federal counterparts in the U. S. Attorney's Office and the U.S. Department of Health and Human Services, Office of Inspector General's Office of Investigations. More information is available at www.fightfraud.ct.gov.
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