Colorado Attorney General Sued Doctor for Medicaid Fraud
The lawsuit alleges a Durango physician submitted over 1,700 fraudulent claims for services rendered without a valid license.
Updated on Sept. 19, 2026 in Substance Abuse
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On September 1, 2026, Colorado Attorney General Phil Weiser filed a lawsuit against Dr. Daniel Caplin for allegedly submitting fraudulent Medicaid claims. The state contends that Colorado Addiction Treatment Services billed for services after its controlled substance license had expired.
Why it matters
The lawsuit alleges that the clinic knowingly operated and billed for medication-assisted treatment despite being unlicensed. This case highlights efforts to maintain the integrity of Colorado Medicaid and ensure services meet state regulatory standards.
The clinic submitted 703 claims for buprenorphine administration worth $270,664 and 1,001 claims for evaluation and management services totaling $103,575. These claims followed the identification of seven rule violations by the Colorado Behavioral Health Administration.
The players
Phil Weiser
He serves as the Attorney General of Colorado and is responsible for representing the state in legal matters.
Daniel Caplin
He is the doctor who operated Colorado Addiction Treatment Services in Durango before dissolving the practice.
Colorado Behavioral Health Administration
This state agency oversees mental health and substance use disorder treatment licensing and regulatory compliance.
The details
The Attorney General alleges the Durango-based clinic continued to bill Medicaid for services between June 2022 and November 2023 while operating without a valid controlled substance license. Dr. Daniel Caplin subsequently dissolved the practice in 2023.
Timeline
March 2022: The Behavioral Health Administration identified seven violations during a visit.
June 2022 - November 2023: The clinic submitted claims while its license was expired.
2023: Dr. Daniel Caplin dissolved the practice.
September 1, 2026: The Attorney General filed the lawsuit in Denver District Court.
The Big Picture
This lawsuit follows a pattern set by Colorado Medicaid provider enrollment and billing requirements regarding the mandate that providers must maintain active, valid licenses to receive state reimbursement.
This lawsuit does not directly alter current Medicaid coverage for patients, but it underscores the state's rigorous auditing of treatment claims. Residents seeking addiction services should verify that their provider currently holds all required state licenses.
The takeaway
Patients participating in medication-assisted treatment programs should confirm their clinic is fully licensed to ensure continuity of care and provider compliance. This legal action serves as a reminder of the importance of state regulatory oversight in preventing healthcare billing fraud.
Further reading
Learn more about oversight and policy regarding Substance Abuse in the state.
Source note: This article includes information reported by Durango Herald.
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