A Mississippi mental health facility has agreed to pay the U.S. government and the state’s Medicaid program nearly $7 million to settle a whistleblower lawsuit alleging it billed Medicaid for preschool day-treatment services that it never provided or that were provided by unqualified personnel. Region 8 Mental Health Services, a publicly funded mental health center based in Brandon, Mississippi, that provides mental health services across five state counties, will pay the Mississippi Division of Medicaid $6.93 million to resolve the whistleblower allegations. The settlement is believed to be the largest False Claims Act health care settlement in Mississippi history, U.S. Attorney Mike Hurst said.

The Mississippi Department of Mental Health reports that nearly 35,000 Mississippi children and adolescents suffer mental health issues that are “severe and persistent.” The state’s Medicaid program defines day treatment as “a behavioral intervention program, provided in the context of a therapeutic milieu, which provides children/adolescents with serious emotional disturbances the intensity of treatment necessary to enable them to live in the community.” Day Treatment services covered by Medicaid provide a vital service to the citizens of Mississippi, enabling the State’s youth to live productive lives and grow to become healthy, productive adults.

The case against Region 8 started after a former employee filed a lawsuit on behalf of the U.S. and state governments under the whistleblower provisions of the False Claims Act, which allows private parties to sue on behalf of the government in cases of fraud. The whistleblower’s allegations were investigated by the U.S. Department of Justice and the Department of Health and Human Services, Office of Inspector General, which discovered that many of the claims Region 8 submitted for payment from 2004 to 2010 were for services that were never provided or were provided by unqualified staff. The federal and state governments backed the whistleblower’s claims. U.S. Attorney Hurst said in a statement:

Our children are among the most valuable and vulnerable in our society, and it is imperative that we do all that we can to protect the programs that offer them the services that they need. The work we do in combatting waste, fraud and abuse in government programs is among some of the most important work this office does, and we will continue to vigorously investigate all allegations of fraud.

The whistleblower who initiated the False Claims Act complaint against Region 8 will receive more than $1 million as a whistleblower award for helping the U.S. and the State of Mississippi recover taxpayer funds.

Source: U.S. Department of Justice



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