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. 




Bradley Square Mall Hosts Mommy And Me Kid's Talent And Fashion Show

Bradley Square Mall will host the  Mommy and Me Kid's Talent and Fashion Show on Saturday, Nov. 8, at 3 p.m. All participants must have a signed pre-registration form filled out and submitted prior to the event. Registration forms my be picked up at Guest Services, Ashton Manor or downloaded from  here. Registration forms are due by  Friday, Oct. 31 . (click for more)

SIGNIX Hires New Vice President Of Partner Development

SIGNiX , a company that provides secure and simple digital signature services announced the hiring of its new Vice President of Partner Development, Leonora Zilkha Williamson. Ms. Williamson will work to identify and target potential partners in a variety of industries.  SIGNiX has long been a partner-centric company that focuses on providing total solutions to software ... (click for more)

2 People Shot Saturday Night On Carousel Road

Two people were shot Saturday evening on Carousel Road. At  9:11 p.m. , Chattanooga Police responded to 1406 Carousel Road on a call of a person shot. One victim on the scene suffered minor injuries.  Another victim was transported by personal vehicle to a local hospital. The s econd victim suffered non-life-threatening injuries.  The suspect ... (click for more)

Teenager Killed In ATV Accident Thursday Night

Damon Lee Jones, 15, was killed Thursday night in an ATV accident in Walker County. It was reported he was riding with a 17-year old, when they tried to enter a church parking lot, but ran into a cable barrier. The accident happened on Dunwoody Road in LaFayette. The other rider, identified as Timothy J. Wallin, was not injured.   (click for more)

Tom Dugan Was A Good Man

Tom was my boss for most of my 36 years at Carta.  At the ceremony where I was awarded my 30-year service award, Tom said, "Don disagrees with 85% of my decisions, but I wish I had 80 more employees just like him." This kind of indicates our relationship. When I asked him to help with my plans for a reunion for the group of Veterans that I served with in Vietnam, he quickly ... (click for more)

Roy Exum: More Sunday Funnies

On the last Sunday before Daylight Savings Time disappears next week, let’s go to my jokes back for some grins and giggles: * * * An old gentleman was on the operating table awaiting surgery and he insisted that his son-in-law, a renowned surgeon, perform the operation.  As he was about to get the anesthesia, he asked to speak to his son-in-law. “Yes, Dad, what is ... (click for more)