HARTFORD, CT — APT Foundation and its chief executive officer agreed to pay $883,859 to the state and federal government to resolve allegations that it double billed Connecticut’s Medicaid program, according to government press releases.
APT Foundation is a behavioral health and substance use disorder service provider with clinics in New Haven, North Haven, and Bridgeport.
APT provides methadone maintenance and detoxification services. Lynn Madden is APT’s chief executive officer, and APT is enrolled as a provider in the Connecticut Medical Assistance Program (CMAP), which includes the Medicaid program. The Department of Social Services (DSS) administers CMAP.
The state of Connecticut and the United States contend that APT and Madden, from January 2016 until November 2016, would refer drug testing services for APT patients to an independent laboratory while, at the same time, APT and Madden submitted claims for payment to DSS for the same APT patients.
As a result, DSS paid for the claims twice, once to the independent laboratory and once to APT.
To resolve the investigation, APT will pay a total settlement of $883,859. The state will receive 50 percent of the settlement, or $441,929.50. The state’s share of funds will be returned to the program.
The settlement was announced by Attorney General George Jepsen and DSS Commissioner Roderick L. Bremby.
“With limited resources available to help those who are truly in need in the opioid epidemic our state and nation currently faces, it is critical that we get the most from each tax dollar spent on treatment,” Jepsen said.
Bremby added that “this settlement of nearly $885,000 from the APT Foundation to the state and federal governments should raise awareness among all enrolled medical providers about the absolute need for careful adherence to billing and claiming requirements.”
The federal government alleges that despite clear guidance from the Medicaid program and the audit finding indicating that on-site drug testing was part of the bundled rate, APT and Madden routinely referred urine drug tests for APT’s patients to an outside, independent lab and, as a result, Medicaid paid for the claims twice.
“Providers who bill government health insurance programs must follow the relevant rules and regulations, and the failure to do so will have serious consequences,” U.S. Attorney John Durham said.
Madden is still listed as CEO of ABT Foundation on the organization’s website.