A Medicaid fraud and abuse lawsuit has been filed, alleging that the perpetrators inappropriately recovered funds through the federal Medicaid program. The Medicaid fraud and abuse lawsuit has been filed against New Era Rehabilitation Center and its owners to recover funds that the defendants allegedly obtained wrongfully through the Medicaid program.

The Medicaid fraud and abuse lawsuit says that the owners of the New Era Rehabilitation Center defrauded the government and the U.S. taxpayers, and a lawsuit was filed under the False Claims Act. The False Claims Act is commonly used by whistleblowers who become aware of insider fraud and illegal activity in a business.

The False Claims Act entitles those whistleblowers who bring forward information that is ultimately used to recover damages to receive a portion of the monies earned. In False Claims Act cases, the United States government has the option to decide whether or not to intervene in the case, or to allow a whistleblower to proceed on their own.

The Medicaid fraud and abuse lawsuit was filed under both the Federal False Claims Act and the Connecticut False Claims Act, arguing that the providers illegally obtained funds through the Medicaid program and are responsible for paying it back.

The Medicaid fraud and abuse lawsuit says that the defendants acted with deliberate ignorance, reckless disregard, or actual knowledge of the laws that were associated with the federal Medicaid program, and listed numerous claims against the rehabilitation center and its owners.

One such claim alleges that the counselling service provided to methadone maintenance patients should not have been billed separately, as the defendants submitted them.

Another aspect of the legal claim alleges that defendants submitted to Medicaid psychotherapy services that were not ever provided to Medicaid beneficiaries.

There are numerous different ways that a Medicaid fraud can be perpetrated, and one such example is when services that were not needed or were never rendered are billed to the Medicaid program as if they were required and happened. The Medicaid fraud and abuse lawsuit also says that the defendants provided counselling services instead of the psychotherapy services that they billed directly at the Medicaid reimbursement rate.

The Medicaid fraud and abuse lawsuit says these fraudulent and false claims were submitted from Medicaid through 2009 to 2013. Although whistleblowers are commonly involved in Medicaid fraud and abuse claims, these are not the only situations that may result in legal action or criminal pursuit of people who have allegedly broken the law.

The U.S. government also has investigative task forces that may identify indications of fraud and abuse. Unfortunately, Medicaid and Medicare fraud and abuse commonly occur throughout the United States and may lead to the government filing a claim to recover as much of the taxpayers’ money as they can.

The Medicaid fraud and abuse lawsuit is Case No. 3:18-CV-00739-VLB, filed in the United States District Court for the District of Connecticut.