Penalty Amount
$1,000,000
The Connecticut Attorney General settled with PCA Pain Care Center and its owner for overbilling Medicaid by using higher billing codes than warranted for services provided. They paid $1 million to resolve allegations under the Connecticut False Claims Act.
PCA and Robinson paid $1 million and an additional $45,000 to offset future audit expenses, and agreed to post-settlement monitoring of billing practices.
In-house legal teams should review all provider-payor agreements, including Medicaid managed care contracts, commercial insurer participation agreements, and any third-party administrator (TPA) arrangements. Focus on clauses governing billing and coding compliance, representations and warranties regarding claim accuracy, indemnification for false claims, audit rights, and termination for regulatory violations. Specific attention is needed for provisions that incorporate by reference payer billing manuals, CPT coding guidelines, and state/federal healthcare program rules. Changes may be required to add mandatory coder training certifications, implement pre-submission coding review protocols, strengthen audit cooperation terms, and clarify liability for overpayments resulting from upcoding or misrepresentation of service levels.
Entity
Robinson PA, LLC d/b/a PCA Pain Care Center
Also known as: PCA Pain Care Center
Industry
Healthcare$2.0M
Attorney General Tong and a coalition of four other states and the FTC sued Zillow and Redfin after Zillow paid Redfin $100 million to shut down its multifamily rental advertising business and transfer clients to Zillow. The settlement requires the companies to restore competition, with Redfin rebuilding its apartment advertising business, and pay $2 million to the coalition.
Attorney General William Tong sent a letter to the Connecticut Insurance Department urging rejection of double-digit rate increases sought by Anthem, ConnectiCare, and UnitedHealthcare for individual and small group health insurance plans covering about 220,000 people. The letter argues the rates exceed inflationary measures and criticizes the carriers for failing to control costs and for poor claims system management, particularly ConnectiCare's transition to Molina Healthcare.
$275K
Connecticut Attorney General William Tong announced a $275,000 settlement with TaxAct, an online tax preparation company, over allegations that between January 2018 and December 2022, TaxAct improperly disclosed detailed customer financial information to Meta and Google through third-party tracking technologies without notifying taxpayers. The settlement requires TaxAct to pay $275,000 and implement new third-party tracking compliance measures, including a review committee, written policies, a tag monitoring system, and two independent third-party audits.
$4.0M
Connecticut Attorney General William Tong and the Federal Trade Commission announced a $4 million settlement with Manchester City Nissan (Chase Nissan LLC) resolving allegations that the dealership double-charged for 'certified pre-owned' vehicles and collected unauthorized junk fees. The settlement requires payment for consumer redress, prohibits misrepresentations, mandates clear disclosure of the maximum total price, and requires express informed consent for all charges.
Attorney General Tong and a coalition of 21 attorneys general and Pennsylvania filed lawsuits against the U.S. Department of Transportation, FMCSA, and DHS to block demands for the personal information of 17 million CDL drivers. The lawsuits allege violations of federal privacy laws and the Administrative Procedure Act, and seek an emergency order to prevent the data transfer.
Attorney General William Tong and a coalition of 10 attorneys general filed a lawsuit challenging a new OCC rule that preempts state laws requiring national banks to pay interest on homeowners' mortgage escrow accounts. The lawsuit argues the OCC ignored federal court decisions and bypassed safeguards, and seeks to block the rule.