Maine employment company settles federal false claims complaint

By Dawn Gagnon, BDN Staff
Posted Aug. 19, 2013, at 6:50 p.m.

PORTLAND, Maine — A Maine corporation that provides services to adults with developmental disabilities and mental health problems has agreed to pay $125,254 to settle federal claims involving improper MaineCare billing.

Employment Specialists of Maine Inc., which has offices in Auburn, Augusta and Bangor, billed Maine’s Medicaid program for services rendered by an excluded provider, U.S. Attorney Thomas E. Delahanty II said Monday.

Delahanty said the United States filed a civil complaint against the corporation alleging that Employment Specialists violated the federal False Claims Act from early 2006 through June 2007 by billing MaineCare for services rendered by a registered nurse who had previously been excluded from participation in all federal health care 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.

The names of excluded individuals are available to providers such as Employment Specialists, Delanty noted.

Documents filed in U.S. District Court in Portland show that despite having submitted an agreement to the Maine Department of Health and Human Services in 2006 certifying that it had not employed and was not employing any provider that had been excluded by the U.S. Department of Health and Human Service, Employment Specialists did, in fact, done so.

After the company was informed that the nurse was an excluded provider, it terminated the nurse’s employment.

He said the complaint sought damages for all of the false claims, along with statutory penalties.

Employment Specialists cooperated in the investigation, he said.

The settlement is the result of an investigation by the U.S. Department of Health and Human Services’ Office of Inspector General and the Maine attorney general’s office.

http://bangordailynews.com/2013/08/19/news/bangor/maine-employment-company-settles-federal-false-claims-complaint/ printed on September 17, 2014