Government alleges Medicaid fraud at California Palms

Documents filed in U.S. District Court are shedding some light on why Federal investigators searched the California Palms Addiction Recovery Campus in Austintown last October, seizing $600,000 from its bank accounts.

A complaint filed on Tuesday by the U.S. Attorney asks the court to force California Palms and operator Sebastian Rucci to forfeit $5,941,096 in Medicaid funds which investigators claim were fraudulently collected.

The government says Rucci and others billed Medicaid for services that were never provided and “upcoded” assessments to maximize Medicaid reimbursements. Upcoding occurs when a healthcare provider submits codes to Medicaid for more serious and more expensive diagnoses or procedures than the provider diagnosed or performed, according to prosecutors.

The complaint also alleges that the 200-bed facility billed Medicaid patients for services that extended beyond the limited thirty-day stay; billed for urine screens that were not rendered, and used personnel without proper credentialing to sign off on patient assessments despite not seeing the patient, and billed Medicaid patients in exchange for free housing.

Source: Government alleges Medicaid fraud at California Palms / WFMJ

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