April Manuel v. B H G Holdings L L C ET AL

CourtDistrict Court, W.D. Louisiana
DecidedApril 1, 2026
Docket2:23-cv-01644
StatusUnknown

This text of April Manuel v. B H G Holdings L L C ET AL (April Manuel v. B H G Holdings L L C ET AL) is published on Counsel Stack Legal Research, covering District Court, W.D. Louisiana primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
April Manuel v. B H G Holdings L L C ET AL, (W.D. La. 2026).

Opinion

UNITED STATES DISTRICT COURT WESTERN DISTRICT OF LOUISIANA LAKE CHARLES DIVISION

APRIL MANUEL CASE NO. 2:23-CV-01644

VERSUS JUDGE JAMES D. CAIN, JR.

B H G HOLDINGS L L C ET AL MAGISTRATE JUDGE LEBLANC

MEMORANDUM RULING Before the Court is a “Motion to Dismiss Pursuant to Fed.R.Civ P. 12(b)(6)” (Doc. 25) wherein Defendants, BHG Holdings, LLC d/b/a/ Behavioral Health Group, BHG LXII, LLC d/b/a BHG Medical Services-Louisiana, VCPHCS VI, LLC d/b/a BHG Lake Charles Treatment Center move to dismiss certain counts of the qui tam Complaint against them for failure to state claims upon which relief can be granted pursuant to Federal Rule of Civil Procedure 12(b)(6) and Federal Rule of Civil Procedure (9)(b). Relator, April Manuel, brings this action on behalf of (1) the United States, by and through its agency, the Department of Health and Human Services (“DHHS”) and the Centers for Medicare & Medicaid Services (“CMS”),; (2) the Department of Defense ("DOD"), Defense Health Agency ("DHA"), and the Department of Veterans Affairs ("VA"); (3) the Louisiana Department of Health, which is responsible for operating the Louisiana Medicaid Program; and (4) herself. Relator has failed to oppose Defendants’ motion and the deadline for doing so has passed.1 As such, the Court accepts Defendants’ Motion and Memorandum in support

thereof as unopposed. BACKGROUND Relator was employed as a Counselor by Defendant, BHG Lake Charles Treatment Center (“BHG Lake Charles”) from May 12, 2022, until her termination on October 23, 2023.2 Defendant BHG Louisiana is a limited liability company that facilitates and provides Opioid Treatment Programs (“OTPs”) to patients throughout southwest

Louisiana, including at the Lake Charles facility, where Relator worked. Defendant BHG Holdings is a holding company that owns and operates OTPs in at least 115 subsidiaries, five of which are located in Louisiana.3 Relator alleges the following fraudulent act/schemes: (1) As of July 1, 2023, after the departure of Clinical Supervisor Naomi Bellard,

there was no Clinical Supervisor (“CS”) who was on duty and on call. By not having a CS, Defendant failed to meet the prerequisite requirement to receive state or federal funding. Because there was no CS present, there was no one to provide supervision to any unlicensed behavioral health professional (“UPs”). Therefore, Defendants failed to comply with the express condition for SAMHSA

1 Doc. 26, Notice of Motion Setting. 2 Complaint, Doc. 1, ¶ ¶ 33, 34. 3 Id. ¶ 41. certification and were not eligible for Medicaid reimbursement from July 1, 2023, through October 23, 2023.4

(2) The OTPs were required to have a sufficient number of licensed mental health professionals (“LMHPs”) to meet the needs of its patients. The UPs, including Relator, had caseloads that exceeded 75 patients. By having such a high caseload, Defendants pressured its employees to take on a much higher caseload than allowed by Federal, State, and local laws and regulations. Relator alleges, “upon information and belief,” that Defendants increased the UPs’ caseloads to

maximize profit, regardless of whether adequate counseling services were ever provided. She further alleges that Defendants knowingly presented, or caused to be presented, a false or fraudulent claim and used or caused to be used a false record of statement material to a false or fraudulent claim.5 (3) UPs must be supervised by LMPHs. According to the Louisiana Counseling

Association, a Provisionally Licensed Professional Counselor must be supervised by an LMHP or a physician.6 Relator alleges that Defendants submitted bills to commercial insurers and Government Health Programs for “false and fraudulent” group therapy sessions.7 She also alleges that Dr. John DiGiglia, the Medical Director, and Deidra Richard, the Program Director,

orchestrated a scheme that pressured and coerced employees to perform

4 Id. ¶ ¶ 280-281. 5 Id. ¶ ¶ 283-303. 6 Id. ¶ 311, 316. 7 Id. ¶ 327. counseling services on patients that were falsely or fraudulently billed that did not occur for the length of time billed and were not conducted by an LMHP.8

(4) Relator alleges she was “forced to participate” in conduct which included falsely documenting that Defendants’ counselors and therapists were performing a certain type of counseling therapy or face disciplinary consequences.9 She alleges that BHG Lake Charles facility counselors and therapists created general templates to combine Reassessments and Brief Addiction Monitor (“BAM”) responses of different patients.10 Relator alleges that the Reassessments and

BAMs were done to “comply” with federal law. Relators allege that the Defendants engaged in this conduct to save time so that they could see more Government Healthcare Program patients without taking the necessary time to provide counseling services.11 (5) To conceal the fraudulent nature of the Reassessments and BAMs, Relator

alleges that the facility shredded the physical copies of these documents. Relator alleges that (1) the purpose of the facility-wide emails with pre-populated templated Reassessments and BAMs was to avoid providing actual therapy to patients and to increase Defendants’ revenue; (2) this policy was directed by Defendants at the corporate level, and (3) Defendants submitted Governmental

8 Id. ¶ 328. 9 Id. ¶ ¶ 331-336. 10 Id. ¶ ¶ 363-365. 11 Id. ¶ ¶ 372-373. Healthcare Programs for false and fraudulent individual counseling therapy sessions.12

(6) Relator alleges that Defendants did not meet the requirements for time billed for the 30-minute therapy session. Specifically, Relator alleges that Defendants consistently billed for more patients than can possibly be seen at the Lake Charles facility during counseling hours.13 Relator alleges that Defendants submitted bills to Government Healthcare Programs for false and fraudulent individual counseling therapy sessions.14

(7) Relator alleges that Defendants did not provide adequate therapy services to its OBOT patients. Relators alleges that patient records reflect that Defendants did not complete Admission Assessments or Comprehensive Assessments on 60 out of 109 patients. Relator alleges that Relator and other employees were requested to backdate the documents and that Defendants submitted claims to

Governmental Healthcare Programs for these false and fraudulent service notes and treatment.15 (8) Relator alleges that Defendants knowingly made false statements, implied certifications, and express certifications that were material to the Governmental Healthcare Programs’ decisions to pay claims for individual therapy and

counseling services at the Lake Charles Facility.16 The falsification of

12 Id. ¶ ¶ 375-378. 13 Id. ¶ ¶ 379-392. 14 Id. ¶ 399. 15 Id. ¶ ¶ 400-415. 16 Id. ¶ 429. Assessments, BAMS and Treatment Plans was knowingly performed at the direction of Defendants at the corporate level.17 Additionally, Defendants

engaged in and continue to engage in a pattern and practice of falsifying OBOT and individual counseling service records for Governmental Healthcare Program beneficiaries at the Lake Charles facilities,18 and submitted false and fraudulent claims for individual therapy and counseling services to Governmental Healthcare Programs for patients.19 (9) Relator alleges that Defendants’ submission of individual or group therapy

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Bluebook (online)
April Manuel v. B H G Holdings L L C ET AL, Counsel Stack Legal Research, https://law.counselstack.com/opinion/april-manuel-v-b-h-g-holdings-l-l-c-et-al-lawd-2026.