Camden clinic accused of phony Medicaid billings

A Camden methadone clinic faces penalties of up to $11.6 million for improperly billing Medicaid, the state and federal health-care program for the needy, New Jersey officials said yesterday.

The Urban Treatment Center - the only methadone clinic in the city and one of just two in Camden County, according to state authorities - is among seven such facilities that improperly billed Medicaid a combined $3.5 million from 2007 to 2009, according to New Jersey's Medicaid inspector general. Urban Treatment's alleged mischarges totaled $906,910.

With a penalty of $1,000 per claim, the inspector general is trying to recover a total of $51.5 million.

"The conduct of these centers demonstrated a complete lack of responsibility over precious Medicaid dollars," Medicaid Inspector General Mark Anderson said in a news release.

He investigated the sites after a spot-check by the state Health Department raised questions about billing, said Niki Trunk, Anderson's chief of staff.

The review found that the seven facilities frequently sent multiple bills when only one charge was allowed, used billing codes that weren't permitted for the tests they did, or charged for tests they did not have equipment to perform, according to the Inspector General's Office.

There are 34 methadone clinics in New Jersey, according to the Department of Human Services.

A woman who answered the phone at the Urban Treatment Center yesterday afternoon said managers and owners had left for the day and could not be reached. Attempts to reach John Holtsclaw, the owner of the Camden facility, were unsuccessful.

The six other centers named in the report are from North Jersey.

The facilities have 60 days to respond to the charges and can appeal the findings to an administrative law judge, Trunk said.

The state's computer systems have been changed to prevent future improper billing, and the clinics cited in the investigation will have to file plans to prevent similar alleged errors, according to the Medicaid inspector general.

"It is just as important, if not more important, to implement changes to the current system so we are not always chasing money after it goes out the door," Anderson said in the release.

Camden's largest methadone clinic, Parkside Recovery, announced in August that it was closing. Besides Urban Treatment, the only methadone clinic operating in the county is in Pennsauken, according to the Department of Human Services.

"We will continue to consult with the Office of the Medicaid Inspector General and respond accordingly so clients can continue to have access to services," said DHS spokeswoman Suzanne Esterman.