By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
As the investigation into a Central Florida mental health counselor continues, new details are emerging on the extent of the $3 million Medicaid fraud scheme. On March 27, 2013, I blogged about a registered mental health counselor arrested on charges of racketeering, Medicaid fraud and identity theft. The Medicaid scheme was through the mental health facility she owned. She is accused of using the public funds for housing, luxury vehicles and buying vacations for several people. On April 26, 2013, the Orlando Sentinel reported new details of the mental health facility owner’s apparently indulgent lifestyle.
Click here to read the previous blog.
Mental Health Counselor Allegedly Bribed People into Handing Over Their Medicaid Numbers.
According to the Florida Office of the Attorney General (AG), between January 1, 2012, and March 27, 2013, the mental health counselor billed Medicaid more than $3 million for services provided to Medicaid recipients with mental health needs that were never rendered. The facility owner is also accused of bribing people with gift cards in exchange for their Medicaid numbers and service applications.
Authorities said the mental health counselor allegedly used the money to buy a cruise trip for seven people, a trip to Mexico, jewelry and more than $175 worth of Louis Vuitton products. Agents allegedly searched the mental health counselor’s home and business. They apparently seized a Cadillac Escalade and a Ducati Superbike from her home, according to the AG.
To read the press release from the AG, click here.
Company Payroll Records Seized-Facility Owner’s Friend Arrested Too.
Investigators also allegedly subpoenaed a third-party payroll company for wage and hour records for the mental health facility, according to the Orlando Sentinel. The records allegedly showed 18 people received checks from the business’s Medicaid-designated account.
It was also discovered a friend of the mental health counselor was the highest paid employee. That employee has a son, who is a Medicaid recipient. She allegedly billed Medicaid $10,490 for services rendered to her son on 99 occasions. The friend was allegedly arrested in April 2013, on charges of racketeering and Medicaid provider fraud.
The Extent of Medicaid Fraud.
According to the Orlando Sentinel, the Centers for Medicare and Medicaid (CMS) estimates between October 1, 2011, and September 30, 2013, there were more than $19.2 billion in improper payments made to Medicare and Medicaid programs nationwide. A chief executive officer of the Washington-based National Health Care Anti-Fraud Association said these schemes are fairly common. He notes one of the biggest challenges facing Medicaid is the need for better screening of providers before they are allowed to bill for services.
Click here to read the entire article from the Orlando Sentinel.
Medicare and Medicaid Investigations and Audits of Mental Health Professionals.
Over the past year we have observed an increasing number of Medicare and Medicaid investigations and audits being initiated against all mental health professionals. We have also seen a number of investigations and audits initiated against psychologists and mental health professionals who treat assisted living facility (ALF) and skilled nursing facility (SNF) residents. There is a two-part blog on our website on this topic. Click here for part one, and click here for part two.
Contact Health Law Attorneys Experienced in Handling Medicaid Audits, Investigations and other Legal Proceedings.
Medicaid fraud is a serious crime and is vigorously investigated by the state MFCU, the Agency for Healthcare Administration (AHCA), the Zone Program Integrity Contractors (ZPICs), the FBI, the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (DHHS). Often other state and federal agencies, including the U.S. Postal Service (USPS), and other law enforcement agencies participate. Don’t wait until it’s too late. If you are concerned of any possible violations and would like a confidential consultation, contact a qualified health attorney familiar with medical billing and audits today. Often Medicaid fraud criminal charges arise out of routine Medicaid audits, probe audits, or patient complaints.
The Health Law Firm’s attorneys routinely represent physicians, dentists, orthodontists, medical groups, clinics, pharmacies, assisted living facilities (AFLs), home health care agencies, nursing homes, group homes and other healthcare providers in Medicaid and Medicare investigations, audits and recovery actions.
To contact The Health Law Firm please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.
What do you think about the mental health counselor’s scheme? Do you think these types of scheme are fairly common? Please leave any thoughtful comments below.
Pavuk, Amy. “Woman Stole from Medicaid, Living High Life, Records Show.” Orlando Sentinel. (April 16, 2013). From: http://www.orlandosentinel.com/news/local/breakingnews/os-medicaid-fraud-janie-vittini-20130426,0,2162535,full.story
Meale, Jenn. “Medicaid Fraud Control Unit and Partners Arrest Ringleader of $3 Million Medicaid Fraud Scheme.” (March 27, 2013). From: http://www.myfloridalegal.com/newsrel.nsf/newsreleases/283E6646009F8B9685257B3B00664A79
About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida, area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.
Tag Words: Mental Health Counselor, Medicaid fraud, Medicaid audit, defense attorney, Medicaid defense attorney, legal defense, Florida defense attorney, Medicaid Scheme, defense lawyer, Medicaid fraud defense lawyer, mental health service program, mental health professional, Medicaid numbers, attorney general’s (AG) office, Florida Medicaid, assisted living facility (ALF), skilled nursing facility (SNF)
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