Behavioral Services Healthcare Provider and its Owner Settle False Claims Act Allegations
For Immediate Release
U.S. Attorney's Office, Eastern District of Virginia
ALEXANDRIA, Va. – Connex Family Services, LLC (Connex), located in Warrenton, and Bianca Riddle, 33, a resident of Gloucester, have agreed to pay $918,000 to settle a civil fraud case that claimed Connex and Riddle submitted or caused false claims to be submitted to Medicaid and TRICARE.
The government alleged that Connex and Riddle submitted claims to TRICARE and Medicaid for applied behavioral analysis services that were not provided during the period from March 1, 2019, through November 13, 2021. Connex’s behavioral analysis services are provided to children who have been diagnosed with Autism Spectrum Disorder and other related disorders.
Connex and Riddle will pay additional amounts, up to $2,053,387, if the company is sold within five years.
As part of the settlement, Connex entered into a three-year Integrity Agreement with the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG). This Integrity Agreement is designed to promote compliance with the statutes, regulations, program requirements, and written directives of Medicaid and all other federal health care programs.
The settlement arises in connection with two lawsuits filed by former employees under the whistleblower provision of the False Claims Act. United States ex rel. Schwartz v. Connex Family Services, LLC, et al., and United States ex rel. Liguori v. Connex Family Services, LLC, et al. The matters were consolidated in the Newport News Division.
A whistleblower suit, or qui tam action under the False Claims Act, is commenced by an individual, known as a “relator,” filing a complaint under seal in the U.S. District Court, and providing a copy of the complaint and other evidence to the U.S. Attorney’s Office. The United States then has an opportunity to investigate the claims. The False Claims Act provides whistleblowers with a share of the government’s recovery.
The resolutions obtained in this matter were the result of a coordinated effort between the U.S. Attorney’s Office for the Eastern District of Virginia; Health and Human Services Office of Inspector General; Department of Defense Office of Inspector General, Defense Criminal Investigative Service; the Federal Bureau of Investigation; and the Commonwealth of Virginia’s Office of the Attorney General.
The matter was investigated by Assistant U.S. Attorney Clare P. Wuerker and former Assistant U.S. Attorney Ilene Albala. Assistant Attorneys General Ray F. Bowman and Jordan E. Sturgis of the Office of the Attorney General for the Commonwealth of Virginia Medicaid Fraud Control Unit handled the matter for Virginia Medicaid claims.
The claims resolved by the settlement are allegations only and there has been no determination of liability.
Updated September 29, 2023
Health Care Fraud