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Minnesota Autism Center to Pay U.S.

Friday, May 28th, 2010 at 5:52 am

The Minnesota Autism Center (“MAC”) has entered into an agreement with the federal government and the State of Minnesota to settle allegations that it improperly billed the federal Medicaid program for autism therapy services. Under the terms of the agreement, signed late yesterday, MAC will pay $600,000 to the United States.

That settlement amount will be divided approximately in half between the federal government and the State of Minnesota, through the Minnesota Department of Human Services (“DHS”), which administers the Medicaid program here in Minnesota.

The MAC, based in Minnetonka, is a health care provider that delivers therapy services to children and families affected by autism, a disorder that alters the brain’s normal development of social and communication skills.

The government investigated the MAC regarding two main allegations related to simultaneous billing and inappropriate billing for client-related activities. Relative to the simultaneous billing allegation, the U.S. asserts the MAC was on notice that it could only bill for skills training simultaneously provided to a child and the child’s family if it received prior authorization to do so.

However, the U.S. contends that the MAC routinely billed for the simultaneous services without receiving such authorization. The client-related activity allegation focused on the MAC’s excessive billing with respect to services such as record keeping and charting. The alleged misconduct took place in 2004 and 2005.

In the settlement agreement, the MAC denies the allegations set forth by the United States and the State of Minnesota and states that it views the agreement merely as a “compromise of disputed claims.” Notwithstanding that, the MAC agrees to provide the United States with the $600,000 in settlement within the next seven days. In return, the United States and the State of Minnesota agree to release the MAC from all claims related to the covered conduct during the relevant time period. The MAC may also continue to participate in the Medicaid program.

This matter resulted from an investigation conducted by the Minnesota Attorney General’s Office and the United States Department of Health and Human Services-Office of Inspector General. Assistant U.S. Attorney Chad Blumenfield represented the U.S.

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