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Tuesday, April 7, 2020

Missouri to receive $2.4 million in Medicaid fraud settlement

By Shaun Zinck | Mar 19, 2015

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Missouri Attorney General Chris Koster announced Wednesday the state would be receive about $2.4 million in a Medicaid fraud settlement. | Missouri Attorney General

Missouri will receive approximately $2.4 million in a Medicaid fraud civil settlement, Attorney General Chris Koster said on Wednesday.

Koster said a lawsuit filed against APS Healthcare, Inc.; APS Healthcare Bethesda, Inc.; and Innovative Resource Group, LLC, doing business as APS Healthcare Midwest, alleged the health care organizations filed false claims to the Missouri Medicaid program. The organizations will pay approximately $5 million to Missouri and the federal government, Koster said.

“It is imperative that the state of Missouri guards its scarce health care dollars in the Missouri Medicaid program,” Koster said. “My office will continue to identify and pursue Medicaid fraud at all levels, from the smallest local providers to large care-coordination companies.”

APS allegedly failed to follow the material contractual terms of two Missouri programs that deal with billing requirements and beneficiary contact. The state and federal government could receive an additional $10 million if APS receives money from a federal lawsuit it filed against Partners Healthcare Solutions Holding, LP, after the Missouri Medicaid programs ended in 2010.

The Missouri Attorney General's Medicaid Provider Fraud Division, the U.S. Attorney's Office for the Eastern District of Missouri and the U.S. Department of Health and Human Services Inspector General's Office of Investigations jointly investigated the claims.

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Missouri Office of the Attorney GeneralState of Missouri