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$625K
Connecticut reached a $625,000 settlement with Frontier Communications Parent Inc. over an April 2024 breach in which compromised employee and vendor credentials were used to access internal systems and exfiltrate unencrypted personal information of 58,841 Connecticut residents. The settlement requires Frontier to strengthen its security program, implement specific safeguards and training, and obtain an independent third-party assessment.
$2.6M
Connecticut and New York found that Boston Children’s Health Physicians and its security vendor, XTIUM, failed to use reasonable safeguards, resulting in hackers accessing sensitive personal, medical, and employee information. The companies agreed to pay penalties totaling $2.64 million and implement enhanced cybersecurity measures.
Connecticut joined a coalition of state attorneys general filing a notice in Character Technologies, Inc.’s bankruptcy proceedings, raising concerns about the company’s safety and privacy practices and the sensitive information it holds. The states seek protections for children and consumers if the company’s business or assets are sold or transferred; the filing does not impose a fine or other remedy.
Attorney General William Tong and Consumer Counsel Claire Coleman petitioned PURA to review how Connecticut public utilities use artificial intelligence, citing potential data privacy and cybersecurity risks, algorithmic errors, and misleading outputs. The petition asks PURA to examine utility AI systems, safeguards, vendors, and data security practices; it does not report a finding of violation or an imposed penalty.
$2.0M
Connecticut Attorney General William Tong announced a settlement with RZ Smoke, Inc. over allegations that it distributed and sold high-potency cannabis products without a state license. The stipulated judgment is $2 million, with $375,000 payable to the State and $1.6 million suspended to ensure compliance; the company is barred from specified cannabis activities in Connecticut unless licensed.
$13.7M
Connecticut joined a coalition of states and the federal government in settling allegations that Takeda paid healthcare providers speaker honoraria and provided meals to induce prescriptions of Trintellix, leading to allegedly false claims to government healthcare programs. Takeda agreed to pay $13,670,921 plus accrued interest, with portions allocated to federal and state programs.