JACKSONVILLE, Fla. – East Coast Stepping Stones Inc., a Jacksonville-based provider for autistic children, paid $360,000 to resolve a False Claims Act allegation that it submitted false claims to the TRICARE program for therapy services for children with autism, the Department of Justice announced Monday.
TRICARE, a federal health insurance program, is for active and retired military members and their families.
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It is alleged that ECSS billed TRICARE for applied behavioral analysis (ABA) therapy services that misrepresented the services provided and who provided them, the DOJ said, adding that ECSS fabricated and altered medical records and failed to document services as required.
“Companies that commit to providing intensive behavioral treatment to children with autism, at a pivotal time of that child’s development, should be held accountable for their actions,” said U.S. Attorney Maria Chapa Lopez. “Our office is committed to protecting federally funded programs that make it possible for children with special needs to receive these vital services.”
ECSS and its leadership agreed to pay the $360,000 in an ability-to-pay settlement.
“This settlement demonstrates the effectiveness of investigations by the Defense Criminal Investigative Service to protect the integrity of Department of Defense programs by rooting out fraud, waste and abuse that diverts and wastes precious American taxpayer dollars intended for our Warfighters and their families," said Special Agent in Charge John F. Khin.
Tips concerning potential fraud, waste, abuse and mismanagement can be reported to the Department of Health and Human Services at 800-447-8477.