Virginia Mental Health Provider Agrees to $1.8 Million Settlement Over Alleged Medicaid Billing Through Its NPI

On October 19, 2026, the U.S. Attorney’s Office for the Western District of Virginia announced that Negril Incorporated agreed to pay over $1.8 million to resolve allegations that the company and its owners violated the False Claims Act (FCA) and the Virginia Fraud Against Taxpayers Act by causing false claims to be submitted to Virginia Medicaid.

The government alleged that, from January 2021 through May 2022, Negril billed Medicaid under its National Provider Identification (NPI) number for mental health skill-building services furnished by another company. That company allegedly lacked its own NPI, state credentialing, and Medicaid enrollment. Negril submitted the claims, remitted 75 percent of the reimbursement to the other company, and retained 25 percent.

The government filed a civil complaint in June 2026 captioned United States et al. v. Negril Incorporated et al., No. 6:26-cv-00066 (W.D. Va.).

Heightened Scrutiny and Compliance Takeaway

HHS-OIG’s resolution page states that Negril will pay the settlement amount over five years and identifies the matter as a heightened-scrutiny resolution. The designation signals continued federal oversight and makes the compliance consequences more significant than the payment terms alone.

The alleged theory is a reminder that a provider cannot lend its billing identity to another entity that lacks required enrollment or credentialing. Healthcare providers using affiliates, subcontractors, or management-service arrangements should verify licensing, credentialing, enrollment, supervision, and documentation requirements before services begin and should test claims against rendering-provider data. Percentage-of-collections arrangements warrant particular scrutiny when one entity bills for services furnished by another because they can obscure who performed the service and whether that provider was eligible for payment.

GWB represents healthcare providers in connection with government investigations and False Claims Act litigation. If you need assistance with such a matter, contact us today.