CARSON CITY – A behavioral health company based in Las Vegas was fined $125,000 today in a Medicaid fraud case involving the failure to maintain adequate records to support Medicaid claims.
Rainbow Child and Family Services was sentenced for one gross misdemeanor offense of intentional failure to maintain adequate records by Clark County District Judge Valerie Adair and ordered to pay the $125,000 in restitution, penalties, and costs.
Persons convicted of Medicaid fraud may also be administratively excluded from future Medicaid and Medicare participation.
“Businesses need to pay attention when processing Medicaid claims,” Masto said. “This office continues to investigate and prosecute Medicaid fraud cases.”
The AG’s office began an investigation after information was obtained that Rainbow was not providing services to Medicaid recipients. Interviews with Medicaid recipients showed that Rainbow was not providing the Basic Skills Training (BST) and Psychosocial Rehabilitation (PSR) services to the recipients as indicated on claims submitted to Medicaid. Furthermore, the documentation to substantiate the claims submitted to Medicaid was inadequate as the records did not note accurate or true dates or types of services provided.
The fraud occurred from August 2011 to April 2012.
The case was investigated and prosecuted by the Nevada Attorney General’s Medicaid Fraud Control Unit (MFCU), which investigates and prosecutes financial fraud by those providing healthcare services or goods to Medicaid patients. The MFCU also investigates and prosecutes instances of elder abuse or neglect.