Medicaid Fraud: CT Health Practice Charged For Services Provided By Unlicensed People, Feds Say

A Connecticut behavioral health practice based in New Haven County defrauded the state's Medicaid program by knowingly billing it for services performed by unlicensed individuals, officials said.

A Hamden-based behavioral health practice defrauded the state's Medicaid program by billing it for thousands of hours of services performed by unlicensed individuals, officials said.
Photo Credit: *Canva/Valerii Evlakhov*

Ben Crnic

04/19/2023 5:00 p.m.

Hamden-based practice K-Assist, owned by Kelly Stutzman, entered into a more than $234,000 civil settlement agreement with both the federal and Connecticut state government to resolve allegations that the practice violated federal and state False Claims Acts, the US Attorney's Office for the District of Connecticut announced on Tuesday, April 18.

According to federal officials, K-Assist, a private behavioral health practice that provided in-home services in the New Haven area, submitted fraudulent claims to Medicaid for psychotherapy services.

The practice would do this by billing Medicaid for thousands of hours of services that were actually performed by unlicensed individuals, according to Connecticut Attorney General William Tong.

The investigation into K-Assist also revealed evidence of repeated billing for excessive services, including hundreds of dates where more than 12 hours of behavioral health services had been allegedly provided by Stutzman in a single day, Tong said.

In order to resolve these allegations, Stutzman and K-Assist agreed to pay $234,064.89 to reimburse the Medicaid program for the conduct, which happened between Feb. 1, 2018, and Aug. 1, 2019.

Under the False Claims Act, the government is able to recover up to three times its actual damages, plus penalties of $13,085 to $27,018 for each false claim, according to federal officials.

In addition to the settlement, Stutzman was also criminally prosecuted by the Medicaid Fraud Control Unit of the Connecticut Chief State’s Attorney’s Office and pleaded nolo contendre to health insurance fraud.

As part of this plea, Stutzman will pay $63,764.23 in restitution and also agreed to be subject to a three-year suspended jail sentence in addition to a five-year conditional discharge.

Tong commented on the case, saying, "We will act aggressively to ensure our Medicaid dollars are used appropriately for the benefit of Connecticut patients."

Connecticut Department of Social Services Commissioner-designate Andrea Barton Reeves also commented, calling the fraud a "serious offense."

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