South Carolina’s Medicaid agency is reviewing dozens of private providers for possible fraud after payments for certain behavioral health services skyrocketed.
The agency says it has referred seven cases so far to the attorney general’s office for potential prosecution. A review of records suggests providers over-billed on hours, billed for services not given and provided unnecessary services.
The problems started last year after the Department of Health and Human Services eliminated a requirement for patients to get a second agency’s approval before receiving care for “rehabilitative behavioral health” services. Such services include treatment and counseling for issues including anxiety, drug abuse and mental illness.
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