Filing False Claims Leads to Court Cases

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A young girl and her mother are in a doctor's office. The daughter is holding a stuffed teddy bear. They are happily talking to their doctor.

The U.S. Justice Department—and, specifically, U.S. attorneys in Connecticut—are cracking down on Medicaid fraud from healthcare providers who file false claims.

In the latest case, a Waterbury licensed professional counselor in children’s behavioral health, has entered into a civil settlement with federal authorities to reimburse Medicaid for $39,400 in claims between November 2014 and March 2017. Channa Sontag and her business, Children’s Behavioral Therapy LLC, were accused of repeatedly billing Medicaid for 60-minute appointments when, in fact, she provided services for less time. As part of the settlement, Sontag agreed to a five-year suspension from participating with Medicaid. (How about suspending her forever?) 

The settlement was part of a larger investigation that also includes the U.S. Department of Health and Human Services and its inspector general, and the Medicaid Fraud Control Unit of the Chiefs State’s Attorneys’ Office. (Where there’s one fraudster, there’s usually more.) These two settlements were also part of the investigation:

  • Arlene Werner, Ph.D., a private psychologist in Waterford, paid more than $126,000 to settle allegations in 2018 that she billed Medicaid for services she did not perform, and that she falsified Medicaid documents between 2011 and 2016.
  • Valerie Williams, LPC, a counselor in Hartford, paid $45,400 to settle allegations in 2019 that she violated the federal False Claims Act by billing Medicaid for services performed by unlicensed workers.

Under the False Claims Act, the government can recover up to three times its actual damages, plus penalties of $11,181 to $22,363 for each false claim. (It’s much cheaper to be honest.)

Today’s Fraud of the Day comes from a U.S Justice Department press release, “Waterbury Licensed Professional Counselor Pays $39K to Settle False Claims Allegations,” released Jan. 24, 2020.

John H. Durham, United States Attorney for the District of Connecticut, today announced that CHANNA SONTAG, LPC, and her business, CHILDREN’S BEHAVIORAL THERAPY LLC, have entered into a civil settlement agreement with the federal and state governments and will pay more than $39,000 to resolve allegations that they violated the federal and state False Claims Acts.

Sontag is a state Licensed Professional Counselor and the owner of Children’s Behavioral Therapy LLC, a private behavioral health practice in Waterbury.  Sontag was enrolled as a Licensed Behavioral Health Clinician in Independent Practice in the Connecticut Medical Assistance Program (“CMAP”), which includes the state’s Medicaid program.  It is alleged that, on numerous occasions, Sontag billed Medicaid for 60 minutes of one-on-one individual psychotherapy services when, in fact, she had performed individual psychotherapy services for less time.

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Larry Benson
Larry Benson is currently the Director of Strategic Alliances for Revenue Discovery and Recovery at LexisNexis Risk Solutions. In this role, Benson is responsible for developing partnerships for the tax and revenue and child support enforcement verticals. He focuses on embedded companies that have a need for third-party analytics to enhance their current offerings.