Hopebridge self-disclosed to OIG and settled for $25,336.48 for submitting claims for treatment plans that were not individualized to the patient as required for reimbursement.

Hopebridge, LLC (Indianapolis, IN) — Non-Individualized Treatment Plans

Outcome: Self-disclosed to OIG and settled for $25,336.48 for submitting Medicaid/Medicare claims for plans of care that were not individualized to each patient as required for valid reimbursement.

Hopebridge, LLC, a behavioral health and autism therapy provider based in Indianapolis, Indiana, self-reported to HHS-OIG that it had submitted claims for treatment services accompanied by plans of care that were "not individualized to the patient." Rather than developing patient-specific treatment plans as required by Medicare and Medicaid coverage rules, the organization submitted standardized plans that did not reflect individualized clinical assessment.

Individualized treatment plans are a core requirement for behavioral health and autism therapy reimbursement — they serve as both the clinical justification for services and the documentation that services are medically necessary for a specific patient. Using non-individualized plans constitutes a false claim because the plans misrepresent the individualized nature of the care being provided.

Hopebridge voluntarily self-disclosed the conduct to OIG and settled for $25,336.48 on October 31, 2025.

Primary Source: Hopebridge Agreed to Pay $25,000 for Allegedly Violating the Civil Monetary Penalties Law by Submitting Claims for Services Without Proper Treatment Plans