Bianca Riddle a resident of Gloucester, and Connex Family Services, LLC, a Warrenton-based company, have agreed to pay $918,000 to settle a civil fraud claim that Connex and Riddle submitted or authorized the submission of false claims to TRICARE and Medicaid.
Connex and Riddle were accused by the government of billing TRICARE and Medicaid for applied behavioral analysis services that were never provided between March 1, 2019, and November 13, 2021. Connex provides behavioral analysis services for children who have been diagnosed with Autism Spectrum Disorder or any similar condition. Connex and Riddle agree to pay up to $2,053,387 in additional consideration for the sale of the company within the first five years.
As part of the settlement, an Integrity Agreement covering three years was signed between Connex and the Office of Inspector General of the United States Department of Health and Human Services. The purpose of this Integrity Agreement is to promote compliance with all applicable federal health care program laws, rules, program requirements, and written directions, including but not limited to Medicaid.
Two former employees filed lawsuits under the False Claims Act's whistleblower provision, leading to the settlement. The United States of America, on behalf of Connex Family Services, LLC, et al. United States ex rel. Liguori v. Connex Family Services, LLC, et al. The cases were merged by the Newport News Division.
Qui tam cases under the False Claims Act are started when an individual, known as a "relator," files a complaint in federal court while keeping the allegations confidential, and then provides a copy of the complaint and any supporting documentation to the U.S. Attorney's Office. The U.S. government would then have the opportunity to investigate the claims. Under the False Claims Act, whistleblowers are eligible to receive a reward of up to 30% of any money recovered by the government.
The resolutions in this case were the result of a cooperative effort between the Federal Bureau of Investigation, the Office of Inspector General for the Department of Health and Human Services, the Office of Inspector General for the Department of Defense, the Defense Criminal Investigative Service, and the U.S. Attorney's Office for the Eastern District of Virginia.
