Connecticut Behavioral Health Clinician Group Pays $234K to Settle False Claims Allegations

Vanessa Roberts Avery, United States Attorney for the District of Connecticut, and William Tong, Connecticut Attorney General, today announced that KELLY STUTZMAN (“Stutzman”), and her business, K-ASSIST, LLC (“K-Assist”), entered into a civil settlement agreement with the federal and state governments and paid more than $234,000 to resolve allegations that they violated the federal and state False Claims Acts.

K-Assist is a private behavioral health practice that provided in-home behavioral health services in the greater New Haven area.  K-Assist is enrolled as a Behavioral Health Clinician Group and Stutzman is enrolled as a Professional Counselor in the Connecticut Medical Assistance Program (“CMAP”), which includes the state’s Medicaid program.

The Government alleged in its civil investigation that Stutzman and K-Assist submitted fraudulent claims to Medicaid for psychotherapy services.  Stutzman and K-Assist falsely represented that a licensed provider had rendered the services when, in fact, an unlicensed individual rendered the services.  To resolve the allegations under the federal and state False Claims Acts, Stutzman and K-Assist agreed to pay $234,064.89 in order to reimburse the Medicaid program for conduct occurring from February 1, 2018 through August 1, 2019.

Under the False Claims Act, the government can recover up to three times its actual damages, plus penalties of $13,085 to $27,018 for each false claim.

In a separate state criminal proceeding, Stutzman pleaded nolo contendre to health insurance fraud.  As part of that plea, Stutzman agreed to pay $63,764.23 in restitution and be subject to a three-year suspended jail sentence and five-year conditional discharge.

This case stems from a larger investigation into fraudulent activity in the area of behavioral health services, which has been jointly conducted by the Office of the Inspector General of the U.S. Department of Health and Human Services, the Medicaid Fraud Control Unit of the Chief State’s Attorney’s Office and the Connecticut Office of the Attorney General, with support from the Connecticut Department of Social Services.

This case was handled by Assistant U.S. Attorney Anne Thidemann, and Assistant Attorney General Joshua L. Jackson of the Connecticut Office of the Attorney General.

People who suspect health care fraud are encouraged to report it by calling 1-800-HHS-TIPS or the Health Care Fraud Task Force at (203) 777-6311.