Today, we’ve published an in-depth look at a Durham and Raleigh mental health provider, Family Legacy Mental Health Services, that received almost $3 million in Medicaid money over the last two years. Yet, many of its past and present employees say they haven’t been paid regularly since March.
A key question here is how this clinic remains a public mental health provider, despite the fact that the organization that oversees public mental health services in Durham and Wake counties, Alliance Behavioral Healthcare, is aware of these allegations.
We received an update from Alliance past deadline yesterday, indicating now that they have taken some steps to sanction the mental health clinic.
Doug Fuller, Alliance spokesman, said the agency imposed a referral suspension on Family Legacy in late July, as the result of multiple complaints and an on-site investigation. In layman’s terms, that means Family Legacy cannot take on any new clients receiving public services. This, of course, means any individual with private insurance can visit the center.
It also means that Family Legacy can continue to work with its existing caseload of Medicaid recipients.
Fuller also said that they served the clinic with a notice of Medicaid overpayment for $46,836.80, meaning that’s public money that must be returned.
Fuller added that Family Legacy “billed for services that do not meet requirements in rules, regulations, state policies and clinical coverage policies mainly in the areas of staffing, timeliness of documentation and billing for activities not covered by the service definition as billable activities.”
As an explanation, there are some activities, such as reviewing of documentation to become familiar with a case, that would not qualify as services fit for billing Medicaid. More as we know it.