A local substance abuse counseling and treatment provider is being sued by the federal government and the state of Rhode Island, which allege that the company billed Medicaid for millions of dollars for services that it failed to provide to patients.
The civil lawsuit, which is against Journey to Hope, Health and Healing and its then-CEO Kenneth L. Richardson Jr., claims the provider "knowingly and routinely failed to provide to their patients who needed these services, and subsequently falsified records in order to make it appear that required services were being provided," according to a news release from the U.S. Attorney's Office Rhode Island District.
From January 2015 to July 2021, the government has alleged that Journey collected over $15 million from the federal-and-state-administered Medicaid program, while failing to provide treatment plans and adequate counseling for patients they were providing methadone with.
The complaint also alleged that management instructed workers to falsify records ahead of reviews by officials and auditors, to make it look like the missing services were delivered.
Federal and state authorities claimed that Medicaid beneficiaries were getting methadone from Journey for years without any required individualized treatment plan in place, and in some cases where plans did exist, they were not updated for years. It's also been alleged that Journey didn't give extra services to patients who tested positive for substances like fentanyl, and maintained caseloads for counselors that were too high to be physically possible.
The feds, as well as state authorities, claimed that over half of the amount claimed by Journey during the time period in question was false, and the government is seeking to recover up to three times the amount paid.
Two former employees first filed action in federal court in October 2020, and the case was unsealed on Monday following the governments' filing.
The case is being investigated by the Office of Inspector General for the Department of Health and Human Services.
