Conn. AG announces settlement with CBHA

By Bryan Cohen | Mar 28, 2013

HARTFORD, Conn. (Legal Newsline) - Connecticut Attorney General George Jepsen and the Department of Social Services announced an agreement Wednesday with Connecticut Behavioral Health Associates to resolve allegations of inappropriate billing of customers.

Federal and state laws require Connecticut Medical Assistance Program providers to accept the CTMAP payment as payment-in-full for covered services. Treatment providers may not directly bill patients for the service. In May 2011, the DSS alleged the CBHA billed approximately 400 patients incorrectly for treatment with Suboxone or Subutex for opioid dependence detoxification over a five-year period.

The DSS directed CBHA to issue refunds to eligible patients. CBHA denied any wrongdoing but voluntarily stopped billing patients directly for the services in September 2011. Under the terms of the agreement, CBHA will pay the funds directly to patients.

"This is fair and equitable resolution that ensures patients receive reimbursement for these treatment services," Jepsen said. "I credit CBHA for stepping up and working with my office and DSS to rectify the problem once they were alerted to the billing errors. I'm pleased that we were able to work with DSS and with CBHA to find a mutually agreeable solution that ultimately puts patients first."

As part of the agreement, CBHA will provide up to $512,224 in refunds to approximately 400 patients enrolled in CTMAP who were directly billed between October 2006 and September 2011. The refunds will be issued to eligible patients in four quarterly groups during a nine-month period starting 60 days after the effective date of the agreement. The DSS will then reimburse CBHA its standard fees for the services rendered.

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