From: mha23x@gmail.com   
      
   Department of Justice   
   U.S. Attorney’s Office   
   Eastern District of Washington   
   FOR IMMEDIATE RELEASE   
   Thursday, January 12, 2017   
      
   Confederated Tribes of the Colville Reservation Enter Into False Claims Act   
   and Voluntary Compliance Agreements Regarding Challenged Youth Counseling   
   Services   
      
   Spokane, WA – Today, the Confederated Tribes of the Colville Reservation   
   (CCT) and the United States of America, acting through the U.S. Department of   
   Justice (DOJ) and on behalf of the Office of Inspector General of the   
   Department of Health and Human    
   Services (OIG-HHS), announced a voluntary settlement agreement reached by the   
   parties relative to allegations that the Colville Tribes submitted false   
   claims to Medicaid seeking the reimbursement of mental health counseling   
   services that was purportedly    
   provided by the Tribe’s Behavioral Health Unit – Youth Counseling services.   
      
       
      
   The CCT is a federally recognized, sovereign Indian tribe, with tribal offices   
   located at Nespelem, Washington, on the Tribes’ reservation. In furtherance   
   of the goals of the Indian Health Care Improvement Act (IHCIA) and to fulfill   
   the United States’   
    trust and treaty obligations to the CCT’s members, the Secretary of HHS and   
   the CCT entered into a Title I Contract and Annual Funding Agreement, on a   
   government-to-government basis, to provide health and social services to   
   tribal members and other    
   eligible individuals. Thus, the CCT is entitled to bill federal health care   
   programs for provided services.   
      
       
      
   Under the agreement, the Confederated Tribes of the Colville Reservation have   
   agreed to pay $245,860 (Two Hundred Forty-Five Thousand, Eight Hundred Sixty   
   Dollars) to resolve false claims allegations arising out of the Tribes’   
   billing irregularities    
   that occurred from January 2010 through August 2010.   
       
      
   During that time, the CCT contracted with an independent mental health   
   contractor to provide youth counseling services. The contractor submitted   
   invoices to the CCT for payment of child mental health encounter sessions. The   
   CCT used these invoices to    
   generate claims that it submitted to the Washington State Medicaid Program for   
   reimbursement. Medicaid administered payment of these encounter session claims   
   with federal funds.   
       
   In 2010, the Federal Bureau of Investigation (FBI), along with the Medicaid   
   Fraud Control Unit (MFCU) and the U.S. Attorney’s Office, began an   
   investigation into allegations that the contractor falsely documented weekly   
   billing invoices for alleged    
   encounter sessions, which the contractor submitted to the CCT for child mental   
   health counseling sessions which were either not provided or were not   
   medically indicated or necessary.   
       
   The investigation found that the contractor conducted a 10-week summer group   
   course, with the same curriculum, year after year, and for the same children.   
   The contractor allegedly submitted invoices to the CCT indicating mental   
   health sessions had been    
   individually provided to each of the children. As alleged, the CCT submitted   
   claims for payment of these false individual counseling sessions to Medicaid   
   based on the falsified invoices.   
       
   The investigation determined that the group sessions were not clinically   
   directed, did not address the patients’ diagnoses, and had little to no   
   clinical value. The CCT was allegedly complacent in its supervision and review   
   of their counseling    
   contractor’s work.   
       
   While the CCT did not admit any wrongdoing, the Office of Inspector General   
   for the U.S. Department of Health and Human Services (OIG-HHS) and the CCT   
   agreed to a settlement that provides for performance of a Voluntary Tribal   
   Compliance Agreement (VTCA),    
   on a government‐to‐government basis, not only aims to enhance the health   
   care services provided to CCT’s tribal members, but also supports CCT in   
   fulfilling its’ obligations under applicable federal law. Per the VTCA,   
   among other things, the CCI    
   will designate a compliance officer and committee, will have an annual review   
   performed by an independent review organization, will establish internal   
   policies and procedures, and will annual reports with the OIG-HHS.   
       
   “This settlement shows both our commitment to protect tax payer dollars and   
   the Colville Tribes’ commitment to providing quality and responsible health   
   and health education services for its’ members,” said Michael C. Ormsby,   
   United States    
   Attorney for the Eastern District of Washington.   
       
   “Fraudulent schemes such as those alleged here drain scarce Medicaid dollars   
   and jeopardize the program’s ability to provide necessary medical care,”   
   said OIG-HHS’s Special Agent in Charge Steven J. Ryan. “Today’s   
   settlement with CCT will    
   help protect tribal children and the program upon which they depend.”   
       
   This case was investigated by the FBI, OIG-HHS, Washington State’s Medicaid   
   Fraud Control Unit (MFCU), and federal prosecutors in the United States   
   Attorney’s Office for the Eastern District of Washington.   
       
   See related case United States v. Debra Van Bunt-Oreiro, Cause No.   
   13-CR-00110-RMP (2014) and related press release at https://www.   
   ustice.gov/usao-edwa/pr/omak-mental-health-counselor-sentenced-f   
   ve-years-probation-filing-false-income-tax   
       
       
   Attachment: Settlement Agreement, January 10, 2017   
   USAO - Washington, Eastern   
   Updated January 23, 2017   
      
      
   https://www.justice.gov/usao-edwa/pr/confederated-tribes-colvill   
   -reservation-enter-false-claims-act-and-voluntary   
      
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