Wisconsin Community Services, Inc. Voluntarily Discloses and Agrees to Pay over $500,000 To Resolve False Billings To Medicare and Medicaid

United States Attorney Matthew D. Krueger announced today that Wisconsin Community Services, Inc. (“WCS”) agreed to pay $537, 904.33 to the United States and the State of Wisconsin to resolve false claims for prescription medications submitted by WCS to Medicare and Medicaid in violation of the False Claims Act, 31 U.S.C. §3729-3733.   

WCS is a not-for-profit corporation based in Milwaukee, Wisconsin. WCS provides a range of services, including outpatient mental health services and an associated pharmacy.  WCS voluntarily disclosed to the United States Attorney’s Office that one of its pharmacists submitted claims to Medicare and Medicaid that misrepresented the prescription drugs dispensed by WCS over several years. For example, WCS dispensed generic formulations of prescription medications but billed Medicare and Medicaid for more expensive name brand formulations of the medications. As a result, Medicare and Medicaid paid WCS significantly more reimbursement than it was entitled to receive. 

“We appreciate that WCS voluntarily disclosed its violations of the False Claims Act and cooperated with the government’s investigation,” stated United States Attorney Krueger. “At the same time, this settlement will make Medicare and Medicaid whole and protect taxpayer funds.”

“Medicare and Medicaid providers cannot misrepresent the drugs they dispense in order to increase their billings,” said Lamont Pugh III, Special Agent in Charge, U.S. Department of Health and Human Services, Office of Inspector General – Chicago Region.  “The OIG will continue to work with our federal, state and local partners to protect the health and safety of Medicare and Medicaid patients and vital taxpayer dollars.”

Assistant United States Attorney Michael Carter represented the government in this matter.  The OIG and the Wisconsin Department of Justice Medicaid Fraud Control & Elder Abuse Unit assisted in the investigation.  The settlement agreement states allegations only; the defendant does not admit liability for the allegations. 

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