East Mental Health Overbilled Medicaid, Court Papers Allege

12/5/17

By Jeff Sturgeon, Roanoke.com

Roanoke-based East Mental Health Services inflated its bills to become the state’s second-highest-paid provider of life-skills training for the severely mentally ill, according to allegations in newly unsealed federal court papers.

In applications for federal search warrants, investigators said the Virginia Medicaid program unknowingly paid millions for care that was billed as one-on-one training but didn’t qualify because it took place at group social events, such as bowling outings, supervised by East Mental Health clinicians. The billing clinicians in some cases spent as little as a few minutes face-to-face with clients, an investigator alleged.

Company principal Christopher Dean East was drawn to the higher compensation rate of $91 for a one-on-one care encounter lasting up to three hours, versus the $24 rate when clients attended a group event, according to a filing by special agent Jeffrey Overbeck with the U.S. Department of Health and Human Services’ Office of the Inspector General.

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