BCLP Recovers More Than $1.2 Million for Client in Medicaid Audit Settlement

BCLP brought a Medicaid audit to a successful conclusion for client Great Circle, a behavioral health nonprofit operating in Missouri and eastern Kansas. Great Circle reached a settlement with the Missouri Medicaid Audit & Compliance (MMAC) Unit in the audit alleging overpayment of claims to Great Circle.

The agreement, announced June 8, affirms that Great Circle will pay only $9,253.18 – less than half of 1% of the alleged overpayment amount of $1,992,157. The state will refund to Great Circle the $1.2 million the organization already paid as required during the appeal process.

In the settlement, MMAC also acknowledged no admission of wrongdoing by Great Circle. All parties have signed off on this agreement and Great Circle has dismissed the appeal that BCLP filed on its behalf before the Administrative Hearing Commission.

The BCLP team, led by Partner Liz Blackwell with support from Richard Finneran, Anne Sharamitaro and Emma Cormier, quickly and efficiently resolved this matter for Great Circle.

“Our success in this case was the product of our team-driven approach to achieving positive results for our clients,” Blackwell said. “By combining our deep knowledge of Medicaid regulation with our broad experience in government-facing litigation, we successfully achieved an overwhelmingly positive result for our client, less than four months after we initially filed our appeal.”

Because Great Circle’s behavioral health work with children and families includes working with multiple funders and donors, Great Circle President and CEO Paula Fleming said it is vital that these entities have faith in the nonprofit’s processes and for Great Circle to be properly reimbursed for the services it provides. 

“Great Circle’s policy is one of transparency – and that includes full cooperation with all reviews, audits and investigations,” Fleming said. “We took this issue very seriously and, through collaboration, we were able to reach a conclusion both favorable to Great Circle and acceptable to the state.”

Great Circle provides a wide variety of services to children and families each year from its multiple campuses and community offices located across Missouri and in eastern Kansas. This successful resolution has been reported by media outlets, including June 9 by the St. Louis Post-Dispatch.