Operators of Day Treatment Program for Children Agree to $15.2 Million Civil Judgment to Resolve Medicaid Fraud Allegations

The operators of a day treatment program for children in Kentucky have agreed to a $15.2 million civil judgment to resolve allegations that they submitted false claims to Medicaid for services that were not covered or not provided as billed. The claims arose from therapy sessions where children were reportedly engaged in non-covered activities including education, recreation, and lunch breaks instead of approved behavioral health services.

The government alleged that the defendants knowingly billed Medicaid for individual and group therapy sessions that did not meet program requirements. This case was initiated through a whistleblower complaint filed under the False Claims Act. The civil judgment includes payment of $12.2 million in restitution to Medicaid and $3 million in penalties.

The resolution highlights ongoing enforcement efforts to protect taxpayer-funded health programs from abuse. Individuals who have witnessed similar Medicaid fraud or improper billing practices are encouraged to seek legal guidance from experienced whistleblower attorneys.