Assistant U. S. Attorney Dylan M. Aste (619) 546-7621
NEWS RELEASE SUMMARY – May 9, 2022
SAN DIEGO – Prism Behavioral Solutions has paid $650,000 to resolve allegations that it billed the state’s Medicaid Program, known as Medi-Cal, for services to autistic children without actually providing care to the children, according to a settlement agreement signed by Prism Behavioral Solutions, the United States, and the State of California.
Prism Behavioral Solutions provides treatment to children diagnosed with autism and other related disorders through therapy called Applied Behavioral Analysis. Prism Behavioral Solutions maintains a corporate address in Woodland Hills, California, and provides medical services to patients in Southern California. The United States and the State of California alleged that Prism Behavioral Solutions violated the federal False Claims Act and the California False Claims Act by knowingly submitting false claims to Medi-Cal for medical services that Prism Behavioral Solutions did not perform from September 2016 through December 2019. According to a whistleblower’s complaint, this included Prism Behavioral Solutions billing Medi-Cal for cancelled appointments.
“Billing government health care programs for services not rendered negatively impacts the entire health care system,” said U.S. Attorney Randy S. Grossman. “This settlement shows our continuing commitment to protect the integrity of government health care programs and other taxpayer-funded...
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