On April 30, a New Jersey-based drug and alcohol rehabilitation facility, Summit BHC New Jersey, LLC, d/b/a Seabrook, agreed to pay $19.75 million to resolve allegations that it violated the False Claims Act by billing for services it was not authorized to provide. This case was initiated by a former Seabrook employee who filed suit under the whistleblower or qui tam provisions of the False Claims Act.

According to the government, Seabrook submitted claims to the Community Care Program of Veterans Health Administration and New Jersey’s Medicaid program for short-term residential treatment and partial hospitalization care, services it was not licensed or contracted to provide. Seabrook also allegedly misrepresented its ability to provide this care to state inspectors.

The government also alleged that, between 2022 and 2024, Seabrook failed to employ enough properly credentialed clinicians and billed for “specialized” veteran care that was no different from what other patients received. The government further alleged that Seabrook maintained false or incomplete records of patient care.

US Attorney Alina Habba stated that this case “demonstrates…[our] commitment to ensure that America’s veterans receive the care they deserve and for which the government has paid. Veterans and Medicaid recipients must receive care from fully qualified, licensed providers in facilities that meet state law in all respects. We stand ready to enforce these standards and protect the Americans who need this care.” 

The Role Whistleblowers Play in False Claims Act Cases

As the Department of Justice reported in its annual roundup of False Claims Act successes, out of the $2.9 billion the government and whistleblowers recovered in 2024, more than $1.67 billion (58% of the total) came from healthcare fraud cases.

Like many False Claims Act case, this one was initiated under the qui tam or whistleblower provisions of the False Claims Act. Under these provisions, private parties (or relators) can file an action on behalf of the government and receive a share of up to 30% of any recovery. The relator in this case will receive an award of more than $3.5 million.

Whistleblower partner Marlene Koury commented: “The government is committed to holding healthcare providers accountable to ensure vulnerable populations get the proper care they need at facilities that comply with the law. Whistleblowers who speak up play a key role in protecting government funded healthcare programs.”

Fraud in Government Healthcare Programs

Government healthcare program fraud can occur in a wide range of government-funded programs, including Medicare, Medicaid, CHAMPVA (a program funded by the Veterans Administration), and TRICARE/CHAMPUS (a health care program for individuals and dependents affiliated with the armed forces). When providers bill for unqualified services or misrepresent the level of care they deliver, they not only break the law, they put patients at risk.

Our Firm Helps Whistleblowers

Constantine Cannon has extensive experience representing whistleblowers under the statute, with numerous record-setting successes.  If you would like to learn more about healthcare fraud, what it means to be a whistleblower under the False Claims Act, or believe you have information relating to a potential case, please contact us. We will connect you with an experienced member of the Constantine Cannon whistleblower team.

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United States Attorney’s Office, District of New York Press Release

Read NJ Rehab Center Will Pay $19.75M to Resolve False Claims Act Allegations at constantinecannon.com