The owner of after-school and child day care programs pleaded guilty to submitting more than $8 million in false claims to Medicaid for mental and behavioral health services that were not provided by a licensed professional – and in many cases were not provided at all.
Victoria Finney Brewton operated a series of after-school and summer childcare programs. She recruited children by promising their parents that the program would be free for Medicaid recipients. After Brewton obtained the children’s Medicaid recipient numbers, she used this information to bill Medicaid for mental and behavioral health services that were never provided.
Brewton was not licensed or qualified to provide mental and behavioral health services, and she was not approved by Medicaid. To implement her mental health fraud scheme, she entered into a conspiracy with Linda Radeker, a licensed professional counselor who was enrolled with Medicaid. Brewton submitted claims to Medicaid as if Radeker had provided the claimed mental and behavioral health services when, in fact, Radeker did not provide any services. Radeker and Brewton then split the Medicaid payments equally.
In 2010, Brewton hired a licensed therapist to provide services at her company. Although the licensed therapist provided some mental and behavioral health services while she was employed by the company, Brewton used the therapist’s Medicaid provider number to submit additional false Medicaid claims for services that were never provided.
Even after the licensed therapist quit, Brewton used the therapist’s Medicaid provider number to continue billing for services not provided. She also submitted an Electronic Funds Transfer Authorization Agreement to Medicaid so that reimbursements for claims submitted through the therapist’s provider number would be deposited into a bank account controlled by Brewton.
The charges of identity theft and billing for services not rendered carry very serious penalties. Brewton faces a mandatory two-year prison sentence and a $250,000 fine for aggravated identity theft, a maximum 10-year prison sentence and a $250,000 fine for health care fraud, and a maximum three-year prison sentence and a $250,000 fine for filing false tax returns that did not disclose the money she received using the therapist’s provider number. She also must pay full restitution to Medicaid.
If you are under investigation or have been charged with a crime – or if you are aware that someone is submitting false claims to the government – then you should consult with an experienced Medicare and Medicaid fraud attorney immediately to protect your rights.
To arrange a free and confidential consultation, call John Howley, Esq. at (917) 652-6504 or click here to reach our offices via email.
John Howley, Esq.
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