by Andrew Murray | July 25th, 2019
On July 17, 2019, Connecticut’s Attorney General announced the lawsuit against Therapy Unlimited and its owner. The defendants allegedly participated in a scheme to submit false claims to the state’s Medicaid program. The Press Release states:
Attorney General William Tong, Connecticut Department of Social Services Commissioner Deidre S. Gifford, and State Comptroller Kevin Lembo, today announced a lawsuit against Therapy Unlimited, LLC and its owner, Catherine Risigo Wickline, for allegedly engaging in pervasive and illegal schemes to submit false claims to Connecticut’s Medicaid program and the state employee/retiree health plan for millions of dollars of reimbursements that they were not entitled to receive.
The lawsuit, to be filed in Hartford Superior Court, alleges that Therapy Unlimited, LLC and Wickline violated the Connecticut False Claims Act by knowingly and systematically submitting thousands of false claims for reimbursement for occupational therapy (OT) and physical therapy (PT) for more treatment time than the therapists actually provided to minor patients who receive health care through Connecticut’s Medicaid program or the state employee health plan.
In addition, the lawsuit alleges that Therapy Unlimited, LLC, and Wickline violated the Connecticut False Claims Act by knowingly submitting more than a thousand false claims for reimbursement for OT and PT delivered to minor patients by unlicensed staff. The lawsuit also alleges that Therapy Unlimited, LLC, breached its provider agreement with the Department of Social Services by billing the Department for services delivered by providers who were not enrolled in Connecticut’s Medicaid program as required by the provider contract and Connecticut regulations.
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Since January 2014, Therapy Unlimited, LLC allegedly billed thousands of claims to the Connecticut Medical Assistance Program, which includes the Connecticut Medicaid Program, for two and a half hours of OT and PT services when patient sessions lasted, on average, less than 45 minutes. Therapy Unlimited, LLC also allegedly billed the state employee health plan for three hours or more of OT/PT services when patient sessions lasted approximately one hour.
Therapy Unlimited, LLC also allegedly used unlicensed staff, including a former OT student and a personal trainer who conducted fitness groups, to provide OT and PT services to children, and then billed Connecticut’s Medicaid program for the services delivered by its unlicensed staff.
The lawsuit seeks damages on behalf of the healthcare plans, civil penalties, costs of investigation and other appropriate relief.
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