Mindpath Care Centers, North Carolina’s largest behavioral health practice, and three of its former officers have agreed to pay $1.9 million to resolve allegations that they submitted false Medicare claims for psychotherapy and related services.
“This large settlement demonstrates our steadfast commitment to protect taxpayer money and to guard the integrity of our vital health care programs,” said U.S. Attorney Ellis Boyle. “Behavioral health practices and other health care providers seeking Medicare funds must make honest claims for payment based upon documented medical need. We will hold those who abuse health care programs accountable. Our office will zealously pursue damages and civil penalties against medical practices who violate the laws.”
“Health care professionals are expected to submit true and accurate billing, which is critical to protecting the integrity of the Medicare program,” stated Special Agent in Charge Kelly J. Blackmon with the U.S. Department of Health and Human Services Office of Inspector General. “This settlement reflects the ongoing commitment of HHS-OIG and the U.S. Attorney’s Office to addressing allegations involving improper billing practices and the potential exploitation of enrollees in our nation’s federal health care programs.”
The case began after whistleblowers alleged that Mindpath fraudulently billed for psychotherapy and medication management sessions without proper documentation or evidence that separate treatments had occurred. The government complaint accused Mindpath of “systematically billed for fraudulent Psychotherapy treatments, without required documentation of the separate time and Psychotherapy treatments of patients to maximize their profits, all in blatant disregard of Medicare billing requirements.”
Federal authorities further alleged that between 2018 and 2020, Mindpath failed to document distinct psychotherapy treatments, did not correct issues raised by employees about improper billing, and continued a pattern described as reckless disregard or deliberate ignorance toward concerns about billing fraud while focusing on generating income.
Under the False Claims Act, entities found liable can be required to pay triple damages plus penalties for each false claim submitted, along with attorneys’ fees for whistleblowers who bring such cases forward. In this instance, Mindpath settled without admitting liability; the civil claims resolved are allegations only.
