By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law, and Michael L. Smith, J.D., R.R.T., Board Certified by The Florida Bar in Health Law

A registered mental-health counselor is accused of running a $3 million Medicaid scheme through the mental health facility she owned, according to the Florida Office of the Attorney General (AG). On March 27, 2013, the facility owner was arrested. She faces charges of racketeering, Medicaid fraud and identity theft. According to the AG, local, state and federal law enforcement officers were all involved in the investigation.

Click here to read the press release from the AG.

Mental Health Counselor Reportedly Billed Medicaid for Services Never Rendered.

According to the Orlando Sentinel, between 2012 and 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 using gift cards to bribe people into letting her use their Medicaid numbers and service applications. Click here to read the entire article from the Orlando Sentinel.

Money was Used on Luxury Items.

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.

The mental health facility owner is charged with one count of second-degree Medicaid fraud, one count of first-degree racketeering, and one count of second-degree identity theft.


Medicare and Medicaid Investigations and Audits of Psychologists and Other 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.
Comments?

Do you think there is an increase in investigations on mental health care providers? Please leave any thoughtful comments below.

Sources:

Meale, Jenn. “Medicaid Fraud Control Unit and Partners Arrest Ringleader of $3 Million Medicaid Fraud Scheme.” Office of the Attorney General. (March 27, 2013). From: http://www.myfloridalegal.com/newsrel.nsf/newsreleases/283E6646009F8B9685257B3B00664A79

Pavuk, Amy. “Bondi: Orlando Woman Ran $3M Medicaid Fraud Scheme.” Orlando Sentinel. (March 27, 2013). From: http://www.orlandosentinel.com/news/local/breakingnews/os-medicaid-fraud-investigation-20130327,0,2857142.story

About the Authors: 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.

Michael L. Smith, J.D., R.R.T., is Board Certified by The Florida Bar in Health Law. He is an attorney with 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.

“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999. 

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