Milestone Recovery, Inc. Agrees to Pay $4,519 to Settle Civil Health Care Fraud Case

Portland, Maine:  United States Attorney Halsey B. Frank today announced that Milestone Recovery, Inc. (“Milestone”) has entered into a civil settlement agreement with the United States and the State of Maine in which it will pay $4,519.04 to resolve allegations that Milestone submitted false claims to MaineCare (Maine’s Medicaid program) from June 2015 through July  2016.  MaineCare is primarily funded by the United States, which pays about two-thirds of all claims submitted to MaineCare. 

According to a civil complaint filed today, Milestone used money paid to it by MaineCare to pay the salary and benefits of a Milestone employee who previously had been excluded from Federal health care and the MaineCare programs.  Federal health care programs may not pay, directly or indirectly, for items or services furnished, ordered, or prescribed by excluded individuals or entities. Prior to joining Milestone, the employee had been excluded after surrendering her nursing license for diverting Fentanyl and Oxycodone while employed as a nurse at a hospital.  The employee disclosed the circumstances that caused her to surrender her nursing license in her Milestone employment application, but Milestone failed to check publicly available exclusion databases to determine if she was excluded.

The case was investigated by the U.S. Department of Health & Human Services, Office of Inspector General, and the Attorney General’s Office of the State of Maine.  The civil action is docketed United States and the State of Maine v. Milestone Recovery, Inc., 2:17-cv-00466-GZS (D. Me.).