The original complaint was filed in 2019 under the qui tam or whistleblower provisions of the False Claims Act.
On April 9, 2021, the United States filed its Complaint in Intervention, partially intervening in a False Claims Act case in the U.S.D.C. for the District of Delaware, bringing claims against Connections Community Support Programs, Inc. (“Connections”), to recover treble damages sustained by, and civil penalties owed to, the United States based on Connections’ conduct. A copy of the Complaint in Intervention can be found below:
According to the Complaint in Intervention, Connections fraudulently billed Medicare and Medicaid by at least (i) billing for mental health services rendered by individuals whose professional qualifications did not allow them to bill Medicare or Medicaid for reimbursement under the names of individuals whose qualifications did allow for reimbursement and (ii) billing Medicaid for mental health services using incorrect procedure codes for the person performing the service, resulting in higher payments to Connections than were permitted. In falsely certifying the identity of the individual providing the mental health service, Connections, in violation of the False Claims Act, caused Medicare and Medicaid to pay for millions of dollars in services for which Connections was not entitled to reimbursement.
The same day the United States filed its Complaint in Intervention, the DOJ announced it in a PRESS RELEASE. According to the DOJ Press Release, the United States alleges that Connections submitted over 4,000 claims to Medicare falsely certifying eligible qualifications for individuals providing mental health services, and over 250,000 false claims to Medicaid, resulting in Connections being paid more than $4,500,000 for mental health services for which it was not entitled to reimbursement.