New Life Lodge Agrees To Resolve TennCare Fraud Allegations For $9.25 Million

Wednesday, April 16, 2014

CRC Health Group has agreed to pay $9.25 million to settle allegations of TennCare fraud related to its New Life Lodge Facility in Burns, Tennessee, Attorney General Bob Cooper announced today.

The State alleged that between 2006 and 2012 CRC provided substandard services, repeatedly exceeded its state-licensed patient capacity, and caused third party pharmacies to bill the TennCare program for prescription drugs that New Life Lodge was obligated to provide to TennCare beneficiaries as part of their TennCare-paid per diem.

The settlement is the result of a joint investigation between the State of Tennessee and the United States. The recovery will be divided between the state and federal governments with the State of Tennessee slated to receive approximately $3.4 million.

“New Life Lodge accepted millions of dollars of TennCare funds with the understanding that it would provide necessary substance abuse treatment services to some of the State’s most vulnerable citizens,” Attorney General Cooper stated in response to the settlement. “Instead, far too often those operating the facility failed to meet their obligations by falling short of minimum necessary standards of care or using third-party pharmacies to double-bill the program.”

In addition to double-billing and licensure issues, the agreement identified several ways the facility allegedly failed to meet acceptable TennCare standards. Among the allegations were that New Life Lodge relied on personnel who were not appropriately licensed or supervised; billed for services that were not documented or provided; failed to conform to the facility’s own patient treatment  plans; failed to provide required access to a psychiatrist; and failed to meet legal “medical necessity” requirements that are prerequisites for payment under TennCare. The settlement agreement provides that it is neither an admission of liability by CRC nor a concession by the State that its claims are not well founded.

Attorney General Cooper emphasized the state’s focus on healthcare fraud in mental health: “Safeguarding TennCare's mental and behavioral health support system is a particular focus of this Office.” The allegations arose from a whistleblower suit filed by former New Life Lodge employee Angela Cederoth on behalf of the State of Tennessee and the United States.  Under the Tennessee Medicaid False Claims Act, a TennCare fraud whistleblower can file a qui tam suit on behalf of the State and receive a portion of the funds recovered. 




CBL Closes Long-Term Fixed-Rate Loan Secured By Ambassador Town Center

CBL & Associates Properties, Inc. on Thursday announced that it closed on a non-recourse $47.7 million loan secured by Ambassador Town Center in Lafayette, La. The seven-year loan bears a fixed interest rate of 3.22 percent and was provided by a new institutional lender. Proceeds from the loan were primarily used to retire the existing construction loans with an aggregate balance ... (click for more)

First Tennessee Bank Presents $50,000 Check To Ancla Insurance And Services

First Tennessee Bank’s Chattanooga Community Development Manager Tracee Smith and Cleveland Community President Mike Griffin presented Ancla Insurance and Services President Beth Underwood with a check in the amount of $50,000 at First Tennessee’s downtown office. The funds donated by First Tennessee will be used to enhance Ancla’s onsite computer lab and build on its lifestyle ... (click for more)

Fire Destroys Highway 58 BBQ

A fire destroyed a barbeque restaurant on Highway 58 on Friday afternoon.   Chattanooga firefighters were dispatched to the Highway 58 BBQ around 6 p.m. The business is located at 4921 Highway 58. Though the business was housed in a small building, the flames and smoke could be seen from a long distance away.  Captain Teri Rose with Quint 6 said the ... (click for more)

2nd Independent Candidate May Be On Walker County Ballot

A second Independent candidate may be on the ballot for sole commissioner of Walker County in the election on Nov. 8. Perry D. Lamb, Jr. has been working toward collecting the necessary 1,640 signatures of registered voters on a petition. His campaign said he is close to the goal. Incumbent Bebe Heiskell is running an an Independent. Election officials said since she was ... (click for more)

Save Coolidge Park - And Response (2)

Last Monday morning while at work a good friend messaged me concerning a matter that I had not heard anything about dealing with Coolidge Park and its future. Apparently that night the City Council was to read an ordinance that would allow the mayor to start negotiations with the relocation of the Medal of Honor Museum. This ordinance would enable the city to lease approximately ... (click for more)

Roy Exum: Tipping The Preacher

I got an unusual telephone call the other day from someone I love who asked my help in solving one of life’s delicate mysteries. It is a tough question: “How do you tip a preacher?” In the first place, you never tip a preacher. It’s the preacher who gives out the tips, helping to keep you on the straight-and-narrow in your quest to waltz through the Pearly Gates. But there are ... (click for more)