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Connecticut And Federal Regulators Announce $1.3 Million Settlement With Substance Abuse Healthcare Provider

Connecticut and federal regulators recently announced a settlement agreement to resolve allegations that New Era Rehabilitation Center (New Era), operating in New Haven and Bridgeport, submitted false claims to both state and federal healthcare programs. The office of George Jepsen, Connecticut Attorney General, announced that New Era:

"... and its co-founders and owners – Dr. Ebenezer Kolade and Dr. Christina Kolade – are enrolled as providers in the Connecticut Medical Assistance Program (CMAP), which includes the state's Medicaid program. As part of their practice, they provide methadone treatment services for patients dealing with opioid addiction. Most of their patients are CMAP beneficiaries.

During the relevant time period, CMAP reimbursed methadone clinics by paying a weekly bundled rate that included all of the services associated with methadone maintenance, including the patient's doses of methadone; the initial intake evaluation; a physical examination; periodic drug testing; and individual, group and family drug counseling... The state and federal governments alleged that, from October 2009 to November 2013, New Era and the Kolades engaged in a pattern and practice of billing CMAP weekly for the methadone bundled service rate and then also submitting a separate claim to the CMAP for virtually every drug counseling session provided to clients by using a billing code for outpatient psychotherapy. The state and federal governments further alleged that those psychotherapy sessions were actually the drug counseling sessions already included and reimbursed through the bundled rate."

These actions were part of the State of Connecticut's Inter-agency Fraud Task Force created in 2013 to investigate and prosecute healthcare fraud. The joint investigation included the Connecticut AT's office, the office of Connecticut U.S. Attorney John H. Durham, and the U.S. Health and Human Services, Office of Inspector General – Office of Investigations.

Connecticut Fight Fraud logo Terms of the settlement agreement require NERC to pay $1,378,533 in settlement funds. Of that amount, $881,945 will be returned to CMAP.

Connecticut residents suspecting healthcare fraud or abuse should contact the Attorney General’s Antitrust and Government Program Fraud Department (phone at 860-808-5040, or email at ag.fraud@ct.gov), or the Department of Social Services fraud (hotline at 1-800-842-2155, online at www.ct.gov/dss/reportingfraud, or email at providerfraud.dss@ct.gov). Residents in other states can contact their state's attorney general's office.

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