South Carolina's largest provider of behavioral therapy for autistic children has paid the federal government $8.8 million to settle allegations of false insurance claims.
Sumter-based Early Autism Project Inc. had been accused of billing Medicaid and TRICARE, which insures military families, for services that were misrepresented in paperwork or not performed at all, federal prosecutors said Thursday in a statement.
Under a deal with the Department of Health and Human Services, the company and its parent, ChanceLight Inc., also agreed to independent oversight of its insurance claims. The firms admitted no wrongdoing under the settlement.
The company has 10 South Carolina sites from Charleston to Rock Hill, along with locations in seven other states, according to its website.
Vice President of Operations Sarah Vega said Early Autism Project has cooperated with the federal probe into billing practices that were put into place before ChanceLight took over the company in 2013. The business has employed several reforms, including a hotline for fielding billing concerns, said Vega.
It settled the case "to continue our focus on providing life-changing" therapy, she said.
"We have been taking every possible action to ensure accuracy and compliance with all regulations," she said. "We look forward to continuing to partner with the state to serve children and families."
The company provides applied behavioral analysis therapy to children and young adults with autism spectrum disorder.
The Department of Justice said in the statement that Early Autism Project had worked to maximize profits by filing insurance claims for administrative or management costs. But Medicaid does not pay for employees not actively working with the patient.
The case started as a lawsuit in U.S. District Court by a former employee, Olivia Zeigler, who as a whistle-blower under the False Claims Act will collect $435,000 of the $8,833,615 settlement, the Justice Department added.
Acting U.S. Attorney Barbara Bowens, who leads the civil division of the U.S. Attorney's Office in South Carolina, said authorities are committed to "protecting the federally funded programs that make it possible for children with special needs to receive these vital services."
People can report potential fraud to the Health and Human Services Department by calling 1-800-447-8477.