• Mon. Mar 4th, 2024

Unraveling a Fraudulent Behavioral Health Scheme Targeting Homeless and Native Americans in Arizona: Kirti Reddy Discusses the Dangers of Unchecked Treatment Center Billing Practices

ByEditor

Feb 13, 2024
Quarles Law Firm: Providing Expert Legal Counsel

In an article published by the American Health Law Association, Quarles & Brady Partner Kirti Reddy discusses a recent case involving one of the largest behavioral health fraud schemes in the United States. The scheme specifically targeted homeless individuals and Native Americans for fraudulent substance use treatment in Arizona.

Reddy, who co-chairs the firm’s Government Enforcement Defense and Investigations team, highlights two main categories of fraud that were uncovered. The first was fraudulent billing by behavioral health treatment providers who were found to be billing for services not actually provided or necessary to the Arizona Health Care Cost Containment System (AHCCCS). Additionally, patient brokering, which involves referring patients to addiction treatment providers in exchange for payment, was also a significant component of the fraud.

The perpetrators of the scheme allegedly bribed victims by offering housing in unlicensed “sober living” homes and enrolled non-Native Americans in Arizona’s American Indian Health Program. Subsequently, victims were sent to behavioral health treatment centers not for the purpose of receiving proper treatment but simply to allow the treatment centers to bill for services to AHCCCS. This exploitation of vulnerable individuals is both disheartening and concerning, and the uncovering of this scheme underscores the need for increased oversight and accountability in the behavioral health industry.

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