A New Hampshire woman has agreed to pay nearly $300,000 in restitution after authorities say she defrauded the Medicaid program out of thousands of dollars when she owned a behavioral health agency in Connecticut.
Kelly Ann Stutzman received a three-year suspended prison sentence Monday from Hartford Superior Court after pleading uncontested to one count of health insurance fraud. She will serve five years of parole, a Hartford judge ordered Monday.
A day after Stutzman was sentenced, federal and state officials announced that she and her company, Hamden-based K-Assist, LLC., had reached a civil settlement. The state and federal governments will receive about $234,000 in compensation under the agreement to resolve allegations that Stutzman violated the False Claims Act, authorities said.
“Kelly Stutzman and her company K-Assist repeatedly billed the Connecticut Medicaid program for thousands of hours of services she claimed to have provided, but instead were provided by unauthorized individuals,” the prosecutor said. Connecticut General William Tong. “In addition to the civil settlement, she also pleaded non-contempt to a criminal charge related to her participation in the Medicaid program. Together with our state and federal partners, we will act aggressively to ensure our Medicaid dollars are used appropriately. for the benefit of Connecticut patients.
According to authorities, between March 2016 and December 2019, claims for behavioral health services submitted by Stutzman were provided by interns and unlicensed individuals, although Stutzman submits bills as if it was providing licensed qualified services. Stutzman also billed for services while clients were hospitalized or in skilled care facilities and services were not provided, officials said.
Federal officials said they uncovered evidence of repeated billing for excessive services, including hundreds of cases in which Stutzman claimed to have provided more than 12 hours of behavioral health services in a single day.
As part of the criminal case, authorities said, Stutzman was ordered to pay about $63,000 in restitution. A Hartford judge also ordered that she not act as a provider in the Medicaid program.
According to the Connecticut State Division of Criminal Justice, by being convicted of a crime related to the program, Stutzman is subject to mandatory disqualification as a health care provider from certain state-funded health programs. federal government in accordance with federal and state laws and regulations.
Legal authorities said Stutzman no longer owns K-Assist.
“Medicaid program fraud is a serious offense and we commend the work of the Attorney General’s office in aggressively addressing wrongdoing in Connecticut’s Medicaid program,” said Department of Human Services Commissioner Designate Andrea Barton Reeves. .
Reeves added, “We appreciate the Attorney General’s efforts to ensure the integrity of Connecticut’s Medicaid program, ensuring that its resources are used to support Connecticut residents and not to enrich those who seek to abuse the system. “
The case against Stutzman stems from a larger investigation into fraudulent activities in behavioral health services, which was conducted jointly by the Office of Inspector General of the U.S. Department of Health and Human Services, l Medicaid Fraud Enforcement Unit of the Chief State’s Attorney’s Office and the Connecticut Attorney General’s Office, with support from the Connecticut Department of Human Services, officials said.
