Bangor counselor to repay Medicaid $64,000 settlement in misbilling case

BANGOR – A Bangor counselor has agreed to repay nearly $64,000 to Medicaid, the U.S. Attorney’s Office in Portland announced Thursday.

Priscilla Torrey Goss of Hampden, who operated Alternatives Counseling Services on Franklin Street in Bangor during the late 1990s, also is required to certify annually for five years that she has no responsibility for billing any federal health care programs.

“Any error in misbilling comes under the rubric of fraud and abuse,” Goss’ attorney, Kenneth Lehman of Portland, said Thursday. “She acknowledged that she made errors in billing [for Medicaid] eight years ago and has refunded the amount she’d been paid to take care of any claims that could have made against her.”

Goss, a licensed social worker and substance abuse counselor, opened the business in 1991. It closed about eight years later.

She will not face criminal charges, Assistant U.S. Attorney Evan Roth of Portland said Thursday.

“The proof [against Goss] was very strong,” he said. “Most people are honestly doing what they need to do to comply with the rules. … We don’t see conduct like this very often.”

The settlement is not expected to have any impact on her license, Lehman said.

Of the 70 Medicaid clients the clinic served, billing irregularities were found in 21, Roth said. Investigators also found that on 26 days, Goss had billed for 12 or more patient hours.

The U.S. Attorney’s Office alleged that between July 1997 and December 1998, Goss and ACS improperly billed Medicaid for:

. Two- to three-hour counseling sessions when the client was seen for about an hour and a half.

. Overlapping counseling sessions in which the same counselor saw two different patients at the same time.

. Substance abuse counseling when the client suffered from another illness not covered.

. Each individual in a family counseling session when only one bill should have been submitted.

. 12 or more counseling hours per day, made up of multiple two- or three-hour sessions.