Catholic Charities West Michigan Agrees to Implement Compliance Program in

MI 2010 Behavioral Health
OIG False Claims
Penalty
$0

Outcome

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Details

Catholic Charities West Michigan Agrees to Implement Compliance Program in — Settlement

Outcome: Official websites use .gov A .gov website belongs to an official government organization in the United States.

Official websites use .gov A .gov website belongs to an official government organization in the United States.

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GRAND RAPIDS, MICHIGAN - Catholic Charities West Michigan, a nonprofit organization based in Grand Rapids, has entered into an agreement with the U.S. Attorney's Office for the Western District of Michigan that requires the agency to implement a compliance program and hire an independent organization to review Catholic Charities' claims for behavioral health services under penalty of a potential exclusion from federal health care programs. The settlement announced today resolves allegations that between May 1, 2010 and December 31, 2013, Catholic Charities' Behavioral Health Unit submitted false Medicaid claims for services that were rendered by a Catholic Charities practitioner with a lapsed license, services that did not comply with applicable supervision and documentation requirements, and services that Catholic Charities upcoded using billing codes for higher-paying services than were actually performed.

HHS Office of Inspector General

How Crucible Prevents This

Crucible's billing compliance controls enforce documentation-to-claims reconciliation, requiring clinical attestation before claims submission and flagging billing patterns that deviate from documented care delivery.

Source: Catholic Charities West Michigan Agrees to Implement Compliance Program in Settlement of Government's False Claims Act Allegations

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