Using Medicaid provider numbers, a company president submitted more than $1 million in claims
January 26, 2016 | By Evan Sweeney
A Dallas woman has been sentenced to 57 months in prison after using the Medicaid provider numbers of four different licensed counselors to submit fraudulent psychotherapy services.
Brenda Ward, president and CEO of H.E.L.P.-Ing Communities Inc., obtained a Medicaid group number and, along with provider numbers, submitted more than $1.6 million in claims to the Texas Medicaid program. Ward used the identites of 290 Medicaid beneficiaries to submit the claims, whcih were for nonexistent individual, family and group psychotherapy sessions between 2009 and 2015. Medicaid paid more than $800,000 of the claims. Announcement
Thank You FHP AF and Mr Sweeny
Another day, another mental health fraudster.
Another constant in an ever changing world.
More from fiercehealthpayer antifraud:
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Home health is still a prime target for business owners who want to bilk the government out of millions, as evidenced by several convictions and sentencings announced last week.
Agents raid compounding pharmacies in multi-state fraud investigation
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Federal and state enforcement agents raided compounding pharmacies in four states as part of a healthcare fraud investigation, seizing more than $15 million in assets, according to various news reports.
Despite repeated warnings, pervasive EHR fraud vulnerabilities remain
January 25, 2016
The push for healthcare providers to adopt electronic health records has been fueled by promises of improved efficiency and usability, greater accessibility to health information, and in some cases, better patient care. Despite multiple warnings from experts, researchers and government agencies, fraud vulnerabilities still exist within current EHR systems, leading to improper billing, and in some cases, brazenly fraudulent records.
N.Y. long-term care plan pays $47M for enrolling ineligible beneficiaries
January 22, 2016
A managed care organization that specializes in long term care in New York City has agreed to pay $47 million for enrolling ineligible beneficiaries in the plan, according to the New York Attorney General's Office.
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