Birmingham billing company pays more than $150,000 to settle fraud allegations

by: Julia Kyles, CPC Jan 19, 2023

Providers are responsible for the claims they submit, but a $153,300 settlement paid by a billing company is a reminder that a practice management company risks disruptive investigations, bad publicity and costly settlements if it is accused of submitting fraudulent claims for a provider.

Amvik Solutions, a Birmingham, Ala.-based company that performs billing, claims and collections for applied behavior analysis (ABA) providers, has joined the list of medical billing companies that have paid settlements to resolve fraud allegations.

According to the Department of Justice’s announcement, the company submitted claims on behalf of Bridgeport, Conn.-based Helping Hands Academy, which provided ABA services for children who have been diagnosed with autism spectrum disorder (ASD).

In 2018, Helping Hands retained Amvik to handle the billing and claims for those ABA services. The government alleges that when submitting claims for payment to Connecticut Medicaid on behalf of Helping Hands, Amvik falsely identified the incorrect Board-Certified Behavior Analyst (BCBA) as the rendering provider on the claims. This caused Connecticut Medicaid to pay claims that it would not have otherwise paid.

The settlement resolves allegations related to actions performed from October 3, 2019, through October 1, 2020.

Nicole Steiner, the owner of Helping Hands Academy was recently sentenced to three years for health care fraud, according to a DOJ press release published Nov. 1, 2022.

From December 2018 to October 2020, Steiner submitted and caused to be submitted fraudulent claims to Medicaid for applied behavior analysis services that were purportedly provided to Medicaid clients.

Steiner’s actions included submitting claims for services that weren’t performed, inflating the number of hours on claims and submitting claims to Medicaid under the name of a former employee.

Blog Tags: anti-fraud, compliance, OIG

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