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Edgewater Systems agrees to pay $1.25 million in settlement over improper Medicaid claims


A Gary health care provider has agreed to pay the state and federal government $1.25 million, in a settlement over improper Medicaid claims.

The U.S. Attorney's Office says Edgewater Systems for Balanced Living repeatedly billed Indiana Medicaid for mental health counseling sessions without having an individualized integrated care Plan that had been signed by a physician or health service provider in psychology. That's despite the fact that Edgewater had been called out on that requirement during prior audits.

The U.S. Attorney's Office says Edgewater did provide the services, but claims that don't meet billing requirements are considered fraudulent claims under the False Claims Act.