Camden Treatment Associates LLC

Camden, NJ 2009--2022 Behavioral Health

DOJ HHS-OIG Medicare Medicaid Fraud Anti Kickback Statute False Claims Act Audit Obstruction

Penalty

$3.1 million

Outcome

Camden Treatment Associates paid $3.15 million and entered a three-year deferred prosecution agreement to resolve criminal and civil claims that it paid kickbacks for methadone mixing services, obstructed a Medicaid audit by submitting falsified documentation, and submitted fraudulent claims to Medicaid.

Details

Camden Treatment Associates LLC — Kickbacks, Audit Obstruction, and Medicaid Fraud (2022)

Outcome: Camden Treatment Associates LLC paid $3.15 million and entered a three-year deferred prosecution agreement to resolve criminal and civil claims that it violated the Anti-Kickback Statute, obstructed a Medicaid audit, and submitted fraudulent claims to government health programs.

Camden Treatment Associates LLC (CTA) operated an opioid abuse treatment facility in Camden, New Jersey, providing methadone maintenance therapy to individuals with opioid use disorder. The case involves two separate fraud schemes spanning more than a decade.

In the first scheme, between 2009 and 2015, CTA and a second company shared common ownership and management. CTA directed all of its methadone mixing services to that second company, paying it more than $125,300 for those services. The second company in turn paid the profits from CTA's orders back to the related parties who controlled both entities — a prohibited self-dealing kickback arrangement under the Anti-Kickback Statute. Because the kickback arrangement influenced CTA's purchasing decisions, all claims submitted to Medicaid for patients receiving methadone mixed by that company were tainted under the False Claims Act.

In a separate criminal scheme, when a Medicaid contractor conducted a routine audit of CTA's claims in 2016, CTA submitted falsified materials to the auditor purporting to justify previously submitted claims. A criminal information was filed on December 2, 2022 in Camden federal court charging CTA with obstruction of a Medicaid audit. CTA entered into a three-year deferred prosecution agreement that imposed compliance requirements and monitoring obligations. CTA also agreed to pay $1.5 million in criminal penalties and $1.65 million in civil damages.

The investigation was conducted by HHS-OIG, the U.S. Attorney's Office for the District of New Jersey, and the New Jersey Medicaid Fraud Control Unit. The case was resolved December 6, 2022.

Primary Source: Opioid Abuse Treatment Facility to Pay $3.15 Million for Kickback Violations, Obstructing Federal Audit, and False Claims Submitted to Government Insurance Programs — DOJ District of New Jersey

How Crucible Prevents This

Crucible vendor relationship monitoring and Anti-Kickback Statute controls would flag a single-vendor lock-in arrangement for methadone mixing services when that vendor shares common ownership with the clinic. Crucible audit readiness protocols and document integrity hooks would detect after-the-fact fabrication of clinical records submitted to a government auditor. A pre-submission audit gate requiring independent review of records before responding to Medicaid auditors would prevent obstruction-category violations.

Source: Opioid Abuse Treatment Facility to Pay $3.15 Million for Kickback Violations, Obstructing Federal Audit, and False Claims Submitted to Government Insurance Programs — DOJ District of New Jersey

Don't let this happen to your organization. See how Crucible works.

See How Crucible Works