Dr. Domonique Randall, the former owner of The Shape of Behavior (“The Shape”), a Texas-based provider of therapy services for children with autism, has agreed to pay $2.7 million to resolve allegations the company submitted improper claims to TRICARE. TRICARE is the health care program for uniformed service members, retirees, and their families.
Dr. Randall lives in Spring, TX. Humana, TRICARE’s managed care support contractor, uncovered alleged improper claims. The settlement resolves allegations that nine separate TSOB locations submitted claims to TRICARE that
- misrepresented the identity of the actual rendering providers
- medical records could not substantiate
- individual providers billed excessive hours on individual dates of service.
The claims resolved by the settlement are allegations only and there has been no determination of liability.
Blue Sprig Pediatrics, also based in Houston, acquired The Shape in October 2018. At that time, The Shape had 22 clinics in four states, including 19 in Texas.