The county has paid the federal government $7 million to settle allegations that its Health Care Agency, Behavioral Health Services Division (OCHCA) submitted false claims to the Medicare Program between 1990 and 1999, according to federal prosecutors today.
Here’s a press release from the Assistant United States Attorney’s office in Los Angeles about the agreement:
Without admitting wrongdoing, the County of Orange paid the settlement to resolve a federal False Claims Act investigation into OCHCA’s billing practices.
The government’s investigation found that during the 1990s, OCHCA billed Medicare for psychiatric evaluations performed by OCHCA personnel that did not meet these requirements. The investigation also concluded that OCHCA had repeatedly billed Medicare for activities that did not qualify as covered mental health services.
The investigation further revealed that during the same 10-year period OCHCA improperly billed and was paid for dispensing self-administered methadone to drug-addicted patients, which is a non-covered service. Finally, the investigation showed that, in a practice known as upcoding, OCHCA had charged brief office visits to monitor or change a drug prescription as more expansive or intensive office visits, resulting in greater compensation.
As part of the settlement, OCHCA has entered into an integrity agreement with the Department of Health and Human Services, Office of Inspector General. The integrity agreement is designed to ensure continuing compliance by OCHCA with Medicare and other federal health programs’ rules and regulations. OCHCA has also voluntarily implemented an ethics-based Compliance Program.
– Rachanee Srisavasdi
