Misrepresentations on Medicaid Application Ultimately Leads to Healthcare Fraud Conspiracy Charges

Earlier this week following a three-day bench trial, the owner of, and a licensed mental health counselor at, a Tallahassee-based counseling center, were found guilty of health care fraud conspiracy, health care fraud, and aggravated identity theft. The counselor was also found guilty of making false statements in connection to health care matters. The convictions ultimately stemmed from the counselor’s inaccurate representation on an application to become a Florida Medicaid provider that she had not been convicted of, or pled guilty or no contest to, a felony, when she’d, in 2016, been convicted of a felony involving Medicaid fraud in the State of New Jersey and had agreed to a five-year debarment from participating in any state Medicaid program.

Evidence presented during the trial demonstrated that the owner of the center knew of the counselor’s conviction and debarment, and that the counselor was therefore ineligible to participate as a Florida Medicaid provider. Nonetheless, from April 2016 through December 2017, the counselor, while under debarment from participation in any State Medicaid Program, caused to be submitted – and the owner submitted – multiple claims to Medicare requesting reimbursement, which claims falsely reflected that another eligible and licensed provider performed the services.

Both the owner of the center and the counselor now face a maximum sentence of 20 years in prison, as well as two years in prison as a mandatory sentence, consecutive to any other sentence imposed. The counselor’s conviction for making false statements in connection to health care matters carries a maximum sentence of five years in prison. This case highlights the negative long-term effects that felony convictions, even when unrelated, can cause in the healthcare sector.

How Frier Levitt Can Help

Frier Levitt has a team of experienced attorneys dedicated solely to defending provider clients against federal healthcare fraud investigations and prosecutions, and collateral consequences which generally flow from these investigations. Contact Frier Levitt today to speak to an attorney.

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