Wisconsin Mental Health Entity, Owner, and Related Party Agree to Voluntary Exclusions
On March 26, 2019, in connection with the resolution of their False Claims Act liability, Acacia Mental Health Clinic, LLC (Acacia), Abraham Freund, and Isaac Freund, agreed to be excluded from participation in all Federal health care programs under 42 U.S.C. § 1320a-7(b)(7). Acacia and Abraham Freund agreed to be excluded for a period of 20 years. Isaac Freund agreed to be excluded for a period of 5 years. At the time of the allegations, Wisconsin Medicaid reimbursed providers for urine drug screens performed with point-of-care cups under Current Procedure Terminology (CPT) Code 80104 at the rate of approximately $20 per test, regardless of the number of drug classes tested. OIG alleged that: (1) at Abraham Freund's direction, Acacia submitted claims to Wisconsin Medicaid under CPT Code 80101 with a separate unit for each drug class, although CPT Code 80101 was appropriate only for more sophisticated tests performed using laboratory equipment that Acacia did not possess; (2) at Abraham Freund's direction, Acacia also misrepresented to Wisconsin regulators that it possessed the laboratory equipment necessary to perform tests covered by CPT Code 80101 to conceal its false billings; (3) Acacia and Abraham Freund knew that, by submitting claims for urine drug screens performed at Acacia under CPT Code 80101, they were misrepresenting the types of tests performed to Wisconsin Medicaid; and (4) by submitting these allegedly false claims to Medicaid, Acacia and Abraham Freund improperly increased the reimbursement received from Wisconsin Medicaid by hundreds of dollars per test. OIG further alleged that Acacia and Abraham Freund submitted or caused the submission of false telemedicine services claims to Wisconsin Medicaid because it was improper to submit claims for telemedicine services provided to patients by psychiatrists located outside of the United States and that, at Abraham Freund's direction and with Isaac Freund's involvement, Acacia performed medically unnecessary and duplicative urine drug screens for its Medicaid patients. Senior Counsel Keshia Thompson represented OIG.
- Date:March 26, 2019
- CMP and Affirmative Exclusions