Integrated Procare Services: Impossible Hours, Absent Visits and Medication-Only Add-Ons

In the Integrated Procare Services fraud case, the practice’s owner and his businesses agreed to pay $614,427 to resolve false-billing allegations involving absent visits, impossible hours and psychotherapy added to medication-only care. The government alleged that claims named the owner as the treating clinician even when he was away, an unqualified person saw the patient, or a staff member simply called in a refill. For someone who knew the office routine, the billing described a different workday.

Integrated Procare Services was a psychiatric medication-management practice in Wethersfield, Connecticut. Its owner was a Connecticut-licensed advanced practice registered nurse. The federal and state governments alleged that he and the practice violated the federal and Connecticut False Claims Acts by causing false claims to reach Medicare and Connecticut Medicaid. The U.S. Attorney’s Office for the District of Connecticut announced the civil settlement on August 6, 2025.

Absent Visits and Impossible Hours

The government’s allegations covered January 2016 through October 2020 and included services never rendered, services by an unlicensed provider, upcoded claims and duplicate claims.

According to the U.S. Attorney’s Office’s announcement, claims listed the owner as the rendering provider for impossible numbers of hours per day. Other claims described services when he was out of the country, on vacation or away from the office. The government also alleged billing for patients who were hospitalized or deceased.

Those allegations put the appointment book, the clinician’s whereabouts and the patient’s circumstances alongside the claim. A bill names a service date and a treating provider. Travel and hospital records can tell a different story about that same date. We connect those facts to the particular billed encounter, because the useful evidence is the contradiction between the work claimed and the work someone could actually have done.

The government was alleging a working day that could not have happened.

Refill Calls Allegedly Billed as Visits

The government alleged that the practice billed under the owner’s name when a staff member called in a medication refill without the owner interacting directly with either the patient or the patient’s medical record. In that account, an office task became a bill for a clinician encounter that never happened.

Someone handling the refill request may know whether the clinician took part, even without deciding how the visit should have been coded.

The announcement also alleged that the owner and the practice created false medical records or had no medical records for these visits. We see the absurdity in the government’s allegation: bill a clinician’s work, then manufacture the account of it.

Unlicensed Care Allegedly Billed Under the Owner’s Name

The unlicensed-provider allegation concerned patients who did see someone, but whose claims named a different person. The government alleged that claims identified the owner as the rendering provider even though an individual with no qualified health professional license or medical qualifications had seen the patients.

For an insider, the question is concrete: who was in the room doing the work that appeared under the owner’s name? Staff assignments, credentials and the treatment record can connect the person who delivered a service to the person represented on the claim.

The Practice, the Care Homes and the Properties

The announcement identified a psychiatric practice, residential-care businesses and property companies under the same owner. It assigned the disputed Medicare and Connecticut Medicaid billing to the owner and Integrated Procare Services.

The owner also controlled two state-funded residential care homes, Brookside in Danbury and Riverview in New Haven, and the companies that held their properties.

We connect the actual treating worker and the billed service to the entity responsible for the claim.

Psychotherapy Add-Ons for Medication-Only Visits

The government alleged that Integrated Procare Services billed for both evaluation and management and psychotherapy during the same visit even though the owner provided only evaluation and management.

A patient’s attendance answers only part of the billing question. The patient may have received medication management while the claim also represents psychotherapy. That added charge makes the clinical account of the visit matter: what treatment did the clinician actually provide?

First Coast’s Medicare psychotherapy coding guidance, revised effective January 1, 2025, describes psychotherapy performed with evaluation and management as a separately identifiable service. The guidance requires documented psychotherapy time, either start and stop times or a total, and excludes evaluation-and-management time from that total.

That explains why the treatment note and the appointment length answer different questions. We look for the psychotherapy actually described and the time attributed to it. The government’s allegation against Integrated Procare was straightforward: the owner provided evaluation and management, while the bill also charged for psychotherapy.

The same distinction appears in the Mindpath Care Centers North Carolina settlement. In that case, the government alleged that psychotherapy and medication-management claims lacked documentation of separate, distinct psychotherapy despite repeated employee concerns. That case shows why an employee’s account of what a medication visit actually involved can matter alongside the codes on a bill.

The Settlement and the Agreement Not to Reapply

The Integrated Procare settlement amount was based on the settling parties’ ability to pay. The owner and the practice also entered into a suspension agreement and consent order with the Connecticut Department of Social Services. They accepted suspension from all programs administered by the department for two years and agreed not to reapply for reinstatement in Connecticut Medicaid or any state-funded program afterward.

The investigation began with analysis of Medicare claims data. The investigating agencies were the Department of Health and Human Services Office of Inspector General, the Connecticut Attorney General’s Office, the Drug Enforcement Administration’s New Haven Tactical Diversion Squad and the Connecticut Medicaid Fraud Control Unit.

What Evidence Does a Whistleblower Need?

For these billing allegations, useful evidence connects the claim to the day it describes. We help you connect what you know about a visit to what the practice billed.

Different employees may see different parts. A scheduler may know the clinician was away. A staff member handling refill calls may know there was no provider interaction. A clinician may recognize a psychotherapy charge for a visit devoted to medication management. We work with that specific knowledge and connect it to the billing and the decisions inside the practice.

These are health care fraud questions about delivered work, documented work and the money claimed for it. You do not have to turn your view of the office into a complete case before speaking with us.

How Much of a Settlement Does a Whistleblower Get?

A whistleblower case under the False Claims Act can pay 15% to 30% of what the government recovers.

You Know What Happened During the Visit

If the billed visit differs from the work you saw, tell our whistleblower experts about the mismatch. We build the case with you and bring in healthcare fraud whistleblower lawyers who understand psychiatric billing, provider qualifications and psychotherapy add-ons. You get partners who stay beside you from the first conversation through the pursuit of a recovery.