December 8, 2017

Opioid treatment provider to pay $884K to settle Medicaid claims allegations

PHOTO | Contributed
PHOTO | Contributed
Attorney General George Jepsen.

A Connecticut opioid treatment provider and its chief executive have reached an $883,859 settlement with the state of Connecticut and the federal government to resolve allegations that the company was improperly reimbursed for claims in Connecticut's Medicaid program, authorities say.

The APT Foundation Inc. (APT), a behavioral health and substance use disorder services provider with clinics in New Haven, North Haven, and Bridgeport, provides methadone maintenance and detoxification services. Lynn Madden is APT's CEO.

The state of Connecticut and the U.S. Department of Health and Human Services contend that APT and Madden referred drug testing services for APT patients to an independent laboratory from January through November of 2016, despite a state Department of Social Services' (DSS) audit that found APT was in violation of a weekly payment rate rule, according to Attorney General George Jepsen and DSS Commissioner Roderick L. Bremby.

That rule, published by DSS in 2015, notified methadone clinics that if a DSS audit found the Connecticut Medical Assistance Program (CMAP) (which includes the Connecticut Medicaid program) had paid another laboratory provider for drug testing within a week of the date a methadone clinic was paid for methadone treatment, the CMAP would reduce the methadone clinic's payment for treatment by the cost of the laboratory service.

"Methadone clinics enrolled as providers in the CMAP have a responsibility to comply with all laws and regulations when they submit claims for payment," Jepsen said. "I credit APT and Ms. Madden for stepping up to rectify their improper claims process while also cooperating with this investigation."

In accord with the CMAP cost sharing between the United States and Connecticut, the state will receive 50 percent of the settlement ($441,929.50). The state's share of funds will be returned to the CMAP.

APT and Madden could not be reached for comment.

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