Maine organization to pay $74,000 settlement in improper MaineCare billing case

Posted March 26, 2013, at 11:59 a.m.
Last modified March 29, 2013, at 1:51 p.m.

PORTLAND, Maine — Support Solutions Inc., a private organization that services adults with developmental disabilities and challenges, has agreed to pay $74,720 in settlement claims involving improper billing to Medicare and MaineCare, U.S. Attorney Thomas Delahanty said Tuesday.

In May of 2007, the U.S. Department of Health and Human Services launched an investigation involving the nonprofit organization’s employment of a program manager who had previously been excluded from participation in all federal healthcare programs. When a person is excluded from federal health care programs, it is improper to bill or receive payment for services rendered by that person, according to a press release from Delahanty’s office.

The names of excluded individuals are available to providers such as Support Solutions, which has offices in Lewiston and Saco. Upon learning of the government’s investigation, Support Solutions terminated the program manager, according to the press release.

After the U.S. attorney’s office and the Maine attorney general’s office joined in the investigation, the United States and the state of Maine filed a civil complaint alleging that Support Solutions violated the federal False Claims Act from May 2006 through May 2007, Delahanty said. The program manager was not named in the press release.

As alleged in the complaint seeking civil penalties, Support Solutions knew or should have known that the Program Manager was excluded from federal health care programs.

The organization was cooperative during the investigation, according to Delahanty.

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