Social Worker Pays $210,000 To Settle FCA Claims

Joseph Ubaghs, a licensed clinical social worker, has entered into a civil settlement with the federal and state governments in which he will pay $210,000 to resolve allegations that he violated the False Claims Act. 

The allegations against Ubaghs involve fraudulent billing to Medicaid for individual and group counseling services.  The government alleged that, on numerous occasions, Ubaghs (i) billed Medicaid for 45 to 50 minutes of individual therapy services when, in fact, he provided less than 30 minutes of counseling services, (ii) billed Medicaid for individual psychotherapy services for separate family members when, in fact, he had provided one group therapy session to the family members at the same time, and (iii) billed Medicaid for counseling sessions that the patients had cancelled and not attended.
 
To resolve the False Claims Act allegations, Ubaghs will pay $210,000 to reimburse the Medicaid programs for conduct occurring between January 1, 2006 and December 31, 2007.
 
Additionally, under the terms of the settlement agreement, Ubaghs is excluded from Medicare, Medicaid, and all other federal health care programs for a period of five years.  This exclusion has national effect and prohibits Ubaghs from receiving payment from any federal health care program during the exclusion period.  It also prohibits payment to any individual or entity, such as a hospital, that employs or contracts with Ubaghs, for any services furnished, ordered, or prescribed by Ubaghs.
 
“Licensed practitioners that participate in the Medicare and Medicaid programs must bill their services honestly, and the failure to do so increases the cost of health care for all of us,” stated U.S. Attorney Fein.  “The U.S. Attorney’s office is committed to vigorously pursuing health care providers who submit fraudulent claims to federal health care programs.  Providers who submit false claims to the government face serious monetary sanctions and exclusion from the Medicare and Medicaid programs.”
 
In addition to the civil settlement, the Medicaid Fraud Control Unit in the Office of the Chief State’s Attorney brought state criminal charges against Ubaghs, which were resolved this week when he was granted Accelerated Rehabilitation.
 
In entering into the civil settlement agreement, Ubaghs did not admit liability.