PRIVATE OKLAHOMA CITY SCHOOL PAYS $354,000 TO SETTLE ALLEGATIONS OF SUBMITTING FALSE CLAIMS TO TRICARE FOR SERVICES PROVIDED TO STUDENTS WITH AUTISM
OKLAHOMA CITY – Good Shepherd Catholic School, Inc. (“GSCS”), paid $354,000 to settle civil claims by the United States stemming from allegations that GSCS submitted false claims to TRICARE for services provided to students with autism, announced United States Attorney Robert J. Troester.
GSCS is a non-profit private educational institution located in Oklahoma City, Oklahoma. TRICARE is a health care program of the United States Department of Defense Military Health System. GSCS serves students with autism and other neurological disorders. As part of its program, GSCS provides Applied Behavior Analysis therapy (“ABA”) services to students diagnosed with Autism Spectrum Disorder. GSCS submitted claims to TRICARE for providing ABA services to TRICARE beneficiaries. TRICARE requires that ABA services be delivered by a TRICARE authorized provider to a TRICARE beneficiary on a one-on-one basis.
The United States alleges that from May 13, 2013, to December 20, 2016, GSCS knowingly submitted false or fraudulent claims to TRICARE for providing ABA services to TRICARE beneficiaries. The claims were allegedly false or fraudulent because the ABA services were provided in a group setting and not on a one-on-one basis as required. To resolve the claims, GSCS agreed to pay $354,000 to the United States.
In reaching this settlement, GSCS did not admit liability, and the government did not make any concessions about the legitimacy of the claims. The agreement allows the parties to avoid the delay, expense, inconvenience, and uncertainty involved in litigating the case.
This case was investigated by the Defense Criminal Investigative Service. Assistant U.S. Attorney Ronald R. Gallegos prosecuted the case.