Journey to Hope, Health and Healing and Former CEO Agree to Pay $10.2 Million to Resolve False Claims Allegations
PROVIDENCE: Journey to Hope Health and Healing (Journey) and its former CEO, Kenneth L. Richardson, Jr., have agreed to pay $10.2 million to resolve allegations that the opioid treatment provider submitted false claims to the Rhode Island Medicaid program and Medicare for substance use disorder treatment services that were not provided.
Journey, when owned and led by Richardson, operated outpatient treatment facilities in Rhode Island that provided substance use disorder treatment services, including methadone-assisted treatment and mental health care services.
The settlement resolves allegations made by the State of Rhode Island and the United States in a complaint in intervention that between January 2015 and July 2021, Journey and its management knowingly submitted false claims to the Rhode Island Medicaid program for millions of dollars.
In April 2023, the United States and the State of Rhode Island filed a complaint in intervention (complaint) under the federal and state False Claims Acts and alleged that Journey failed to provide required treatment plans and adequate counseling services to certain patients receiving methadone treatment. The complaint also alleged that Journey maintained patient caseloads at a volume so high that it was physically impossible for counselors to provide required counselling services.
The complaint further alleged that Journey and its management knowingly falsified documents by altering and backdating records to make it appear to accreditation officials and Rhode Island Medicaid auditors that they were complying with the accreditation requirements necessary to bill Rhode Island Medicaid.
Under the settlement agreement, Journey and its CEO will pay $10.2 million to the United States and the State of Rhode Island to resolve their alleged liability under the federal and state False Claims Acts. The settlement includes the resolution of claims brought under the qui tam, or whistleblower, provisions of the False Claims Acts by former Journey employees Sara Quaresma and Michael Delmonico. Under those provisions, private parties may file civil actions on behalf of the government and receive a portion of any recovery. Under the settlement agreement, the whistleblowers will receive approximately $2.04 million of the settlement proceeds.
The matter was investigated by the U.S. Attorney’s Office for the District of Rhode Island, the U.S. Department of Health and Human Services, Office of Inspector General; the R.I. Office of the Attorney General; the R.I. Executive Office of Health and Human Services; and the R.I. Department of Behavioral Healthcare, Developmental Disabilities and Hospitals.
The case was handled by former Assistant U.S. Attorney Bethany Wong with assistance from Assistant U.S. Attorney Kevin Bolan; Special Assistant Attorney General Kate Constance Brody of the Rhode Island Attorney General’s Medicaid Fraud Control and Patient Abuse Unit; and Genevieve M. Allaire Johnson, the former Director of the Rhode Island Attorney General’s Medicaid Fraud Control and Patient Abuse Unit.
