Recovery Network of Programs, Inc. (“RNP”), a healthcare organization that provides substance abuse and mental health services in Fairfield County, has entered into a civil settlement agreement with the federal and state governments in which it will pay $354,367 to resolve allegations that it caused overpayments for urine drug testing services to be paid by the Connecticut Medicaid Program. RNP entered into contracts with the State of Connecticut Department of Social Services (“DSS”) to provide behavioral health and substance use disorder services to Medicaid beneficiaries. DSS conducted an audit of RNP and found that both RNP and an independent laboratory billed Medicaid for drug testing performed by the laboratory, contrary to DSS’ weekly rate payment regulation.
In January 2016, DSS issued an Audit Report warning RNP that continued non-compliance with the weekly rate payment rule would result in financial disallowances in future audits. The 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, RNP routinely referred urine drug tests for RNP’s patients to an outside, independent laboratory. As a result, Medicaid paid for the claims twice, once to RNP pursuant to the bundled rate and a second time to the outside laboratory. To resolve its liability, RNP will pay $354,367 to the federal and state governments for conduct occurring between March 1, 2017 and October 17, 2017.
