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August 4, 2015

Ga. care firm to repay CT $154K

Connecticut will collect a six-figure share of a multi-state, $2.8 million settlement with a Georgia pediactric and home-care provider accused of failing to return overpayments from state Medicaid and other federally funded health programs, authorities say.

The state’s top civil and criminal prosecutors and the chief of the state Department of Social Services (DSS) jointly announced Tuesday the settlement with Pediatric Services of America (PSA), of Norcross, Ga. Its operating units – Pediatric Healthcare Inc. and Pediatric Home Nursing Services – are also part of the settlement, authorities said.

State Attorney General George Jepsen, Chief State’s Attorney Kevin T. Kane and DSS Commissioner Roderick L. Bremby said the state and federal settlement share of Connecticut’s Medicaid program amounts to $264,689.58. Of that, the state will net $153,998.08, they said.

Also covered in the settlement are Arkansas, California, Colorado, Florida, Georgia, Illinois, Indiana, Louisiana, Massachusetts, New Jersey, New York, North Carolina, Ohio, Oregon, Pennsylvania, South Carolina, Texas, Virginia and Washington, and federally-insured health programs, including Tricare/TriWest and Medicare.  

The states had alleged that PSA knowingly failed to return overpayments that it received from state Medicaid programs on claims submitted between January 2007 and June 2013. PSA is also alleged to have created a billing system that double rounded minutes employees worked, which would create an overcharge to states’ Medicaid programs and overstate the length of time services were provided.

“Improper and fraudulent billing claims against our Medicaid program will not be tolerated,” Jepsen said in a statement. “We take allegations of fraud and abuse very seriously, and we will continue to work to hold accountable those who seek to defraud and overcharge our taxpayers.

As part of the settlement, PSA also agreed to close monitoring of its future marketing and sales practices by the U.S. Department of Health and Human Services and the federal Office of the Inspector General.

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