Tampa, FL – United States Attorney Maria Chapa Lopez announces today that Behavioral Consulting of Tampa Bay (“BCOTB”) has agreed to pay the United States $675,000 to resolve allegations that BCOTB violated the False Claims Act by submitting false or fraudulent claims to the TRICARE program, a health care program for uniformed service members, retirees, and their families.
The United States initiated an investigation after an audit by TRICARE’s managed care support contractor (Humana Military Program Integrity) revealed alleged false or fraudulent claims to TRICARE for applied behavior analysis therapy (“ABA”) and other services to TRICARE beneficiaries with autism spectrum disorder. Today’s settlement resolves allegations that BCOTB submitted claims to TRICARE that (1) misrepresented the identity of the rendering provider, (2) misrepresented the service provided, (3) requested payment for more units of time than supported by the medical record, and (4) were not substantiated by a medical record, and therefore requested payment for services that were not rendered.
“Companies that commit to providing intensive behavioral treatment to children with autism, at a pivotal time in their development, should be held accountable for their actions,” said U.S. Attorney Maria Chapa Lopez. “Our Office is committed to protecting our military service members and their families and the programs that make it possible for their children with special needs to receive these vital services.”
"In this case, the provider's overbilling cheated TRICARE out of money meant for children's therapeutic services," stated Special Agent-in-Charge Cynthia Bruce of the Defense Criminal Investigative Service (DCIS) Southeast Field Office. "DCIS will aggressively pursue those who exploit government programs intended to help our military service members, veterans, and their families and will dedicate all needed resources to bring them to justice."
Today’s settlement results from a coordinated effort by the U.S. Attorney’s Office for the Middle District of Florida, assisted by the Defense Criminal Investigative Service and Humana Military Program Integrity. Assistant United States Attorney Lindsay Saxe Griffin led the civil investigation.
The claims resolved by this settlement are allegations only, and there has been no determination of liability.