Clifton Park Telehealth Company to Pay $300,000 to Resolve Allegations of Improper Billing for No-Show Visits and Other Services

ALBANY, NEW YORK - First Assistant United States Attorney John A. Sarcone III announced today that Clifton Park-based Aptihealth, Inc. and Aptihealth Medical, PLLC (Aptihealth), a behavioral health provider operating a telehealth platform, will pay $300,000 to resolve False Claims Act allegations concerning its Medicare and Medicaid billing practices. This settlement is part of the Department of Justice's 2026 National Health Care Fraud Takedown.

"Aptihealth submitted claims to Medicare and Medicaid that did not comply with program requirements," said First Assistant United States Attorney Sarcone. "The integrity of these programs depends on accurate billing and adherence to established rules. I commend the former employee who brought these issues to the government's attention. The Healthcare Fraud Task Force is committed to identifying and holding accountable those who act with disregard of taxpayer dollars."

"Violations of the Anti-Kickback Statute and False Claims Act can negatively affect the integrity of federal health care programs, undermining resources upon which millions of beneficiaries depend. In this case, the defendants' actions artificially created demand for services and siphoned off funds for services that were never provided," said Naomi D. Gruchacz, Special Agent in Charge of the U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG). "HHS-OIG is committed to working with our law enforcement partners to safeguard federal health care programs and ensure the return of funds that were falsely received."

As part of the settlement, Aptihealth admitted responsibility for certain billing conduct described in the settlement agreement. This includes billing Medicare and Medicaid for patient appointments that did not occur because the patient was a "no-show," billing for responses to patient messages without regard to whether such communications involved billable clinical content, and billing for psychological testing services that were not sufficiently documented.

Aptihealth also implemented an incentive program that involved a small number of patients who received a $25 gift card after attending a therapy session, which the United States contends violated the Anti-Kickback Statute.

Finally, Aptihealth admitted that its compliance program failed to meet certain New York statutory requirements relating to billing oversight, compliance monitoring, and training and education.

The settlement resolves a whistleblower lawsuit filed under the qui tam provisions of the False Claims Act by a former Aptihealth employee. The Act allows private persons to file civil actions on behalf of the government and share in any recovery. Under the settlement, the whistleblower will receive approximately $51,000 of the settlement proceeds. The case is docketed with the U.S. District Court for the Northern District of New York under number 1:23-cv-878.

This year the Administration launched the Task Force to Eliminate Fraud and the National Fraud Enforcement Division to enhance the Administration's war on fraud, waste, and abuse in federal programs. When unscrupulous actors exploit these programs for their own financial gain, they defraud the government, harm the people these programs are designed to aid and protect, and undermine American businesses that play by the rules. False Claims Act enforcement plays a critical role in combatting such fraudulent schemes, recovering billions of dollars for the American taxpayers, and holding wrongdoers accountable. False Claims Act matters will continue to be on the forefront of the battle against fraud, and our False Claims Act work will support and advance the mission of the Task Force to Eliminate Fraud and the National Fraud Enforcement Division.

The United States Attorney's Office for the Northern District of New York jointly investigated this matter with the Office of the New York Attorney General's Medicaid Fraud Control Unit. Assistant U.S. Attorney Christopher Moran represented the United States.