Aug 13, 2020 - Health

Unsealed lawsuit alleges Molina overbilled for children's mental health

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Molina Healthcare headquarters in Long Beach, California Photo: Jeff Gritchen/Digital First Media/Orange County Register via Getty Images

A newly unsealed lawsuit accuses Molina Healthcare of cutting corners in its mental health services for children and defrauding Medicaid in the process.

The big picture: Molina provides Medicaid managed-care plans in more than a dozen states. The whistleblower suit accuses the company of overbilling specifically for children's behavioral health services, to the tune of at least $20 million across multiple federal, state and local agencies.

Details: The lawsuit, which was filed in 2018 but under seal until last month, claims that Molina and two of its subsidiaries failed to maintain individualized treatment plans for some of the children it covered, as required by law. 

  • The company billed some care as if it had been supervised by a professional, even when it wasn't, the lawsuit says, and didn't give some of its providers the proper training.
  • The suit also alleges that Molina provided care for kids who weren't eligible, either because their conditions were too severe for this kind of counseling to make a difference or because their family members couldn't or wouldn't take part in Molina's therapy sessions.
  • And it says Molina illegally fired an employee who complained about those practices.

The other side: Spokespeople from Molina did not respond to a request for comment on the suit.

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