AG Tong Announces Settlement With Cornell Scott Hill Health Corporation

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08/11/2021

Lawyer Normal Tong Announces $350,000 Settlement With Cornell Scott Hill Overall health Corporation Over Dental Services Overbilling

(Hartford, CT) – Attorney Typical William Tong now declared a $350,000 joint state and federal settlement with Cornell Scott Hill Wellbeing Company (CSHHC) resolving allegations that the New Haven-primarily based health and fitness center carried out a coverage that resulted in overbilling the state’s Medicaid plan for selected dental services.

CSHHC is a community-centered Federally Competent Health Middle (FQHC). The Connecticut Medicaid program makes use of an “encounter-based” reimbursement design to compensate FQHCs for all providers provided to Medicaid recipients on the identical working day. Less than this product, a FQHC is paid a pre-established “encounter rate” that addresses all solutions received by a affected individual for the duration of a check out to that FQHC. Each individual time a affected person returns to a FQHC to acquire a services or providers, the FQHC gets paid out another face rate. CSHHC’s latest face price is about $162.00.

A joint condition and federal investigation uncovered that from 2017 by way of 2019, CSHHC carried out a coverage that required Medicaid people to receive regime dental cleanings and exams on independent times. This policy resulted in CSHHC finding paid two come across costs for companies that could have been concluded all through the similar take a look at. CSHHC cooperated with the investigation.

“Cornell Scott Hill applied a plan that brought about the state Medicaid application to overpay for program dental companies. This policy burdened people by needlessly necessitating repeat visits for their dental examinations and cleanings. This policy experienced genuine penalties for their Medicaid clients, which includes demanding older people and kids to acquire a lot more time off work and/or university, as well as the load of added transportation. In addition to the $350,000 restitution payment, Cornell Scott Hill will let all Medicaid clients the capability to routine each their dental cleansing and examination in a person go to,” reported Legal professional Normal Tong.

Lawyer Standard Tong thanked the U.S. Overall health and Human Expert services Office environment of the Inspector Typical/Workplace of Investigations, the Workplace of the United States Legal professional, and the DSS Office of Quality Assurance for their guidance and coordination in this issue.

Anyone with information of suspected fraud or abuse in the community health care procedure is asked to speak to the Lawyer General’s Antitrust and Government Program Fraud Office at 860-808-5040 or by e mail at [email protected] the Medicaid Fraud Command Unit at 860-258-5986 or by electronic mail at [email protected] or the Division of Social Providers fraud reporting hotline at 1-800-842-2155, on the net at www.ct.gov/dss/reportingfraud, or by email to [email protected]

Assistant Lawyers Common Joshua L. Jackson and Michael E. Cole, Authorized Investigator Kevin Jeffko, and Jeremy Pearlman, Main of the Antitrust and Authorities System Fraud Office, assisted the Attorney Basic with this matter.

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