Georgia gets $7.8M in settlement

by Keith Loria |
Feb. 23, 2011, 3:45pm


ATLANTA (Legal Newsline) - Georgia Attorney General Sam Olens announced on Tuesday that his office has reached a $7.8 million settlement with a health care company that allegedly violated the state's False Claims Act.

Innovative Resources Group LLC, doing business as APS Healthcare Midwest, of White Plains, N.Y., allegedly submitted false claims to Medicaid through the Georgia Department of Community Health.

Between Sept. 1, 2007 and Feb. 28, 2010, the company allegedly didn't provide the correct specialty services in regards to disease management and case management to members of the Georgia Medicaid Management Program.

The Georgia Medicaid Management Program contract called for APS Healthcare to provide these services and collect a monthly fee for each member receiving either disease management or case management service. The suit alleges that APS Healthcare failed to provide the required services to a large percentage of the Medicaid recipients and that DCH was overbilled in its monthly invoices.

"This substantial recovery of taxpayer dollars is attributable to the continued strong partnership between state and federal law enforcement agencies in the fight against healthcare fraud and abuse," Georgia Senior Assistant Attorney General Scott Smeal said.

"This case should send a strong message to companies such as APS Healthcare that they will be held fully accountable if they fail to provide the services they promised to provide to Medicaid patients."

The state of Georgia will receive $7.8 million under terms of the settlement, while an additional $5.2 million will be paid towards the federal share of Georgia Medicaid expenditures.

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