WALNUT CREEK, CA — A Walnut Creek behavioral medicine services firm has agreed to pay $2.75 million to resolve allegations that they submitted false claims to government health care payers, according to the Department of Justice.
American Psychiatric Centers, Inc., which does business under the name Comprehensive Psychiatric Services, has submitted claims using Current Procedural Terminology codes 90833 and 90836, which are add-on codes used when psychotherapy services are performed with an evaluation and management visit, which requires specific documentation.
The government alleges that from Jan. 1, 2015 through Dec. 31, 2022, CPS submitted fraudulent claims using these add-on codes in instances where its providers had either not provided the services described by these codes, or failed to sufficiently document that such services had been provided.
CPS agreed to pay $2,615,569.32 to the United States and $134,430.68 to the state of California.
“Veterans and their families expect and deserve the highest quality healthcare delivered in a safe and accountable setting,” said Dimitriana Nikolov, special agent in charge with the Department of Veterans Affairs Office of Inspector General’s Northwest Field Office. “This settlement is a testament to the VA OIG’s commitment to safeguarding the integrity of VA’s healthcare programs and preserving taxpayer funds.”
Anyone who suspects potential health care fraud, waste, abuse or mismanagement can contact the Department of Health and Human Services at 800-447-8477.