Edgewater Systems for Balanced Living, Inc., in Gary agreed to a $1.25 million pre-suit settlement for fraudulently billing the Indiana Medicaid system for mental health treatment, according to a Friday release from U.S. Attorney Clifford D. Johnson.
Michael LeBroi, chief information officer for Edgewater, referred comment to Danita Johnson, the agency’s president and CEO. She did not return a request for comment.
Indiana Medicaid, which receives both state and federal funding, requires providers to draft a care plan for clients receiving mental health counseling services that is signed by either a physician or a health service provider in psychology, a provider with a Ph.D. in psychology, before any treatment sessions are conducted or Medicaid is billed for them.
“Despite knowing of the requirement because of negative Indiana Medicaid audits during prior time periods, during the period from November 1, 2012 through and including December 31, 2017, Edgewater repeatedly billed Indiana Medicaid for mental health counseling sessions that failed to meet the requirement,” the release states.
The False Claims Act prohibits an entity from knowingly submitting claims for payment to a Medicaid program that fail to comply with required billing standards, according to the release.
Under the False Claims Act such noncompliant billing constitutes a fraudulent claim even though services were in fact rendered. Edgewater has agreed to pay the United States and the State of Indiana $1.25...
A new exchange of sharp political statements has emerged after US President Donald Trump made claims on Truth Social that were directly rejected by Iran’s Parliament Speaker Mohammad Bagher Ghaliba...