Behavioral Health

On January 29, the New York State Office of the Medicaid Inspector General (OMIG) published its 2025 Work Plan, which provides a preview of the OMIG’s program integrity initiatives for the upcoming year. While this post highlights several areas that the OMIG will focus on, Medicaid providers should refer to the Work Plan for…

The U.S. Attorney’s Office for the District of Connecticut recently announced that Supportive Care Holdings, LLC and its related companies agreed to pay the federal government nearly $4,600,000 to resolve allegations of submitting false claims. The Supportive Care companies provide behavioral health services via telehealth to patients residing in skilled nursing facilities.

Supportive Care’s companies…

The owner of Bergen Alliance Counseling Services in Paramus, New Jersey pleaded guilty to a run-of-the-mill healthcare fraud scheme in District Court in Newark on March 19. Maria Cosentino of Garfield, a licensed clinical social worker, admitted to billing private healthcare programs for counseling sessions that did not take place.

The practice provided counseling services…

A March 11 article in Part B News, “Warning: Minor Errors Can Mean Big Takebacks for AWV Claims,” discussed how compliance shortcomings can cause problems for claims to Medicare for annual wellness visits (AWVs). Rivkin Radler’s Mary Aperance was quoted in the article.

“Routine internal audits should be conducted to hone in…

On December 19, Michael Lonski, a Greenwich psychologist, was sentenced to a 27-month prison term and three more years of supervised release for a scheme to defraud Medicaid. Lonski submitted over 80,000 claims from 2014 to 2019, and in calendar year 2017 he submitted claims for services on all but one day—including holidays and weekends.

The U.S. Department of Health and Human Services’ Office for Civil Rights (OCR) announced on May 8 that David Mente, a Pittsburgh psychotherapist, has paid $15,000 to settle a violation of the HIPAA Privacy Rule. OCR has been pursuing its so-called Right of Access Initiative since 2019, as previously discussed here.

Incredibly, some healthcare…

In the case Brokamp v. James, the U.S. Court of Appeals for the Second Circuit on April 27 affirmed the dismissal of Elizabeth Brokamp’s suit against New York officials. The Virginia-licensed mental health counselor’s suit claiming that New York’s licensing laws violated her right to free speech was previously dismissed by a lower court.…

An audit by the New Jersey Office of the State Comptroller (OSC) found that John Gore, a licensed drug and alcohol counselor, improperly billed and received over $1 million in Medicaid payments for services provided between 2016 and 2020. Gore will be required to repay the sum of $1,160,371. 

Significantly, Gore billed for clinical level…

The U.S. Attorney for the District of Connecticut recently announced that Michael Lonski, a Greenwich psychologist, pleaded guilty to healthcare fraud. Lonski admitted to billing insurers for services that were not rendered, including for deceased patients, and for dates of service when he was out of the country, or his medical partner was out of…