DOJ and Evergreen Treatment Services settle allegations regarding double billing of government health programs

Seattle – The U.S. Department of Justice today resolved double billing allegations against Evergreen Treatment Services, announced U.S. Attorney Tessa M. Gorman. The settlement is on behalf of the U.S. Department of Health and Human Services (HHS) which runs the Medicare program and other government health plans. Evergreen Treatment Services will pay the government $1,453,982 to resolve the matter.

“I want to commend the data analysis work done by our Affirmative Civil Enforcement unit and HHS-OIG to identify the double billing,” said U.S. Attorney Gorman. “We want to be sure taxpayer dollars are safeguarded so they can legitimately go to critical services such as drug treatment.”

“Providers that participate in Medicare are obligated to bill for services honestly and lawfully. Submitting false claims diverts funding from essential health services, including critical drug treatment, which puts both patient well-being and federal health care programs at risk,” said Special Agent in Charge Steven J. Ryan of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG). “This settlement shows that HHS-OIG will continue to work with our law enforcement partners to detect and deter actions that threaten the Medicare program and its enrollees.”

According to the settlement agreement, in January 2020, Medicare began paying for drug treatment services including medically assisted treatment. Evergreen, a non-profit based in Seattle, submitted claims in 2020 for the period January 1, 2020, to July 2020 and those claims were paid.  The claims are paid weekly, and services are bundled: medications, counseling, therapy, toxicology testing, intake activities and periodic assessments are billed under one billing code.

Evergreen then knowingly resubmitted bills that had already been paid. This conduct continued from January 8, 2021, to February 26, 2021. Evergreen was improperly reimbursed for these services. These double billings totaled $726,991.

Of the $1,453,982 settlement, $726,991 is restitution and the rest is a penalty under the False Claims Act.

This matter was handled by Assistant United States Attorney Matt Waldrop and Ryan Hardy, investigative analyst with the U.S. Attorney’s Office. HHS-OIG and the DEA Diversion Control Division provided significant investigative assistance.