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Colville Tribes to pay $250K in settlement

 


The Colville Tribes will repay the federal government nearly a quarter million dollars to settle allegations it submitted false Medicaid claims in connection with bills submitted by a mental health contractor for services allegedly never rendered, U.S. Attorney Michael Ormsby announced in Spokane late Tuesday.

The tribes, which have not admitted to any wrongdoing, agreed to pay $245,860 for alleged “billing irregularities” between January and August 2010, said a press release from Ormsby, the United States Attorney for the Eastern District of Washington.

At the time, the tribes were using an independent contractor from Omak, Washington, for “child mental health encounter sessions,” the U.S. attorney said. The tribes submitted that contractor’s invoices for payment from the Washington State Medicaid Program, which uses federal funds.

“In 2010, the Federal Bureau of Investigation (FBI), along with the Medicaid Fraud Control Unit (MFCU) and the U.S. Attorney’s Office, began an investigation into allegations that the contractor falsely documented weekly billing invoices for alleged encounter sessions, which the contractor submitted to the CCT for child mental health counseling sessions which were either not provided or were not medically indicated or necessary,” Ormsby’s office said.

That office, along with the FBI and the Medicaid Fraud Control Unit, found bills for a 10-week “summer group course, with the same curriculum, year after year, and for the same children” that indicated “mental health sessions had been individually provided to each of the children,” the U.S. Attorney Office said. “As alleged, the CCT submitted claims for payment of these false individual counseling sessions to Medicaid based on the falsified invoices.”

The investigating agencies found that the sessions “were not clinically directed, did not address the patients’ diagnoses, and had little to no clinical value,” and that the CCT “was allegedly complacent in its supervision and review of their counseling contractor’s work.”

The allegations are related to the 2014 conviction of Debra Van Brunt-Oreiro, of Omak, who was sentenced to five years probation for filing false income tax returns and ordered to pay $250,172 in unpaid taxes to the IRS.

Van Brunt-Oreiro was the owner-operator of ADJR Counseling Services in Omak, and provided mental health counseling and therapy services to Colville Confederated Tribal (CCT) members and non-members.

She filed false income tax returns for 2006, 2007 and 2008, which under-reported income she received from the CCT by approximately $575,616. She also failed to file a 2009 federal income tax return, even though she earned approximately $233,737 in income that year, Ormsby’s office announced at the time.

According to its Voluntary Tribal Compliance Agreement with the Office of Inspector General for the U.S. Department of Health and Human Services, the CCT will designate a compliance officer and committee, have an annual review performed by an independent review organization, will establish internal policies and procedures, and will submit annual reports to HHS.

“Fraudulent schemes such as those alleged here drain scarce Medicaid dollars and jeopardize the program‘s ability to provide necessary medical care,“ said OIG-HHS’s Special Agent in Charge Steven J. Ryan. “Today‘s settlement with CCT will help protect tribal children and the program upon which they depend.”

Tribal Business Council Chairman Mike Marchand could not be reached for comment late Tuesday.

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