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June 19, 2018

Waterbury clinician to settle CT Medicaid fraud

By Gregory Seay

A Waterbury private social worker must repay Connecticut $200,000 and accept a 10-year ban to settle civil claims he abused the state's Medicaid program, authorities say.

Elijah Caldwell is a licensed clinical social worker and owner/operator of a pair of Waterbury behavioral health practices -- A Prospering Vision LLC and Home of Hope Inc., the state Attorney General's Office said Monday.

As previously reported, between March 2013 and Dec. 2016, Caldwell billed the state's Medical Assistance Program (CMAP) – which includes the state's Medicaid program – for counseling services that purportedly were provided to CMAP patients at A Prospering Vision and Home of Hope, according to investigators with George Jepsen's office and the state Department of Social Services.

The state alleged that many of the psychotherapy services Caldwell billed to DSS either were never rendered to CMAP patients or were provided by unlicensed individuals. The state also alleged Caldwell overcharged CMAP for actual or non-existent services.

Under the settlement, both A Prospering Vision and Home of Hope also are banned for a decade from participating in CMAP, authorities said.

Whether related state or federal criminal charges are pending against Caldwell could not be immediately determined Monday.

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