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Herman Law Group Clients’ Whistleblower Suit Under the False Claims Act Leads the United States and State of Rhode Island to Recover $10.2 Million from Outpatient Treatment Center and its Former CEO
[EAST PROVIDENCE, RI] – The Herman Law Group is pleased to announce that the United States and State of Rhode Island have settled a False Claims Act case alleging that an opioid treatment provider submitted false claims for reimbursement to the Rhode Island Medicaid program. The case was initially brought by two former employees against The Journey to Hope, Health, and Healing, Inc. and its former CEO.
The United States and State of Rhode Island joined the whistleblower lawsuit filed by Attorney Louise Herman of Herman Law Group against The Journey and its then CEO, Kenneth L. Richardson, Jr. alleging serious violations of the federal and state False Claims Acts that included billing the Rhode Island Medicaid program millions of dollars for substance use disorder treatment services that had not been delivered to patients and falsifying documents by altering and backdating treatment records.
The “qui tam” or whistleblower complaint was originally filed under seal in 2020 by Herman Law Group on behalf of two former Journey employees. In April 2023, the United States and the State of Rhode Island intervened and filed a complaint in intervention. The complaint alleged that despite holding itself out as a certified and accredited opioid treatment provider, the Journey routinely failed to provide treatment plans and adequate counseling to patients receiving methadone, while the Journey collected millions of dollars from Medicaid. According to court filings, in preparation for upcoming reviews by officials and other auditors, Journey management falsified records to create the appearance that services had been provided when they had not been.
“It was a privilege to represent these two brave whistleblowers, Sara Quaresma and Michael DelMonico, who were employees of this company. This settlement is a testament to the skill, commitment and tenacity of an outstanding team of government attorneys and investigators who held those that profited accountable for their actions,” Attorney Herman said.
Ms. Quaresma, Mr. DelMonico and their attorney express appreciation to the federal and state prosecutors. In particular, they thank former U.S. Attorney Zachary Cunha of the District of Rhode Island; former Acting U.S. Attorney Sara M. Bloom; U.S. Attorney Charles Calenda; former Assistant U.S. Attorneys Bethany N. Wong; Assistant U.S. Attorney Kevin Bolan; Rhode Island Attorney General Peter F. Neronha; Special Assistant Attorney General Kate Constance Brody of the Rhode Island Attorney General’s Medicaid Fraud Control and Patient Abuse Unit; and Genevieve M. Allaire Johnson, former Director of the Rhode Island Attorney General’s Medicaid Fraud Control and Patient Abuse Unit for their hard work and thorough and detailed investigation and litigation.
“The government’s intervention here underscores its goal of protecting vulnerable patients, rooting out fraud and recouping tax dollars,” said Attorney Herman.
A copy of the United States’ press release can be viewed here.
About the False Claims Act
The False Claims Act permits private parties to sue on behalf of the government and to receive a share of the recovery. These cases are filed under seal by law. The government then decides whether to join the case following an investigation. Whistleblowers can be rewarded anywhere between 15% and 25% of the recovery under the False Claims Act when the government intervenes, and between 25% to 30% of the recovery when pursuing a remedy without government intervention. The settlement agreement in this government intervened case provides for the whistleblowers to receive approximately $2.04 million of the settlement amount.
Case Information
The case is captioned U.S. ex rel. Quaresma and DelMonico v. The Journey To Hope, Health and Healing, Inc. et al., Case No. 20-cv-00451.
Herman Law Group is devoted to representing whistleblowers in matters involving healthcare fraud, defense contracting fraud, PPP fraud, prevailing wage fraud, tariff fraud and securities fraud. For more information, contact Herman Law Group at 401.277.4110 or email Louise A. Herman at lherman@lhermanlaw.com or Darlene Morris at dmorris@lhermanlaw.com.