Two members of the DJO Whistleblower Law Group, Managing Partner, Daniel Ocasio and Christopher Piacentile, CFE, played key roles in the settlement by Georgia psychotherapy services to resolve false claims allegations.
A Roswell-based psychotherapy services provider, Carenow Services, LLC (along with its CEO) has agreed to resolve allegations of violating the False Claims Act. This was completed by billing Medicare and Medicaid for psychotherapy sessions at nursing homes that were either incorrectly documented, medically unnecessary, or billed at higher rates, which is a process known as ‘upcoding.’ The civil settlement was reached by Assistant U.S. Attorney Armen Adzhemyan, the civil Elder Justice Coordinator, and Georgia Assistant Attorney General Sara Vann.
The major counts of this fraudulent activity can be summarized as follows:
- Between 2012 and 2018, Carenow billed Medicare and Medicaid for psychotherapy sessions at nursing homes/facilities that did not have any medical necessity.
- Where the sessions were needed medically, Carenow upcoded these services and billed Medicare and Medicaid at higher rates.
Full details of the settlement can be found here.
This case is a prime example of how organizations can take advantage of existing programs like Medicare and Medicaid and use it to their financial benefit. These two members of the DJO Whistleblower Law Group played a key role in this case. Managing partner, Daniel Ocasio, worked tirelessly as part of the litigation team and Director of Investigations, Christopher Piacentile, was the originating and lead investigator. As stated by Chris himself, “Early on, it was quite evident that the fraud here was egregious when we discovered that the company was submitting bills for psychotherapy sessions for deceased patients. This provider would treat the chart, and not actually see or visit the patient before submitting their bill.” This settlement showcased the dedication and expertise that these two individuals bring to the DJO Whistleblower Law Group.
Daniel Ocasio, Christopher Piacentile, and the rest of the team would like to thank the U.S. Attorney’s Office for the Northern District of Georgia, the Georgia Medicaid Fraud Control Unit, and Health and Human Services—Office of the Inspector General, and the Federal Bureau of Investigations for their swift and complete closure of this case. Whistleblowers tend to receive between 15%-25% of the settlement once it is complete. Coming forward as a whistleblower in general is not an easy task, but it is an important one that can make a difference.
If you find yourself in a position where you witness fraudulent activity, reach out to our team here. We will provide a supportive, confidential environment to speak freely, and assist in holding organizations accountable.