If you’re billing the government for services that you never provided, you’re committing fraud. (Just a general rule of thumb.) As stated in a press release, the Georgia Attorney General’s office prosecuted a woman who owned and operated an Atlanta-area behavioral health clinic for submitting to Medicaid hundreds of thousands of dollars in illegal claims. (The so-called “Family Functions” clinic turned out to be downright dysfunctional.)
In less than two years, this woman billed the government-sponsored health care program for more than $650,000 in services through her main office and another facility in northern Georgia. When the Georgia Medicaid Fraud Control Unit investigated the nature of the high volume of claims being submitted by this single clinic, it uncovered that the owner charged the government for appointments with Medicaid recipients that it never actually treated, visits that were improperly documented or services that were incorrectly documented. Ultimately, the stolen money didn’t even go back into the clinic, but was instead spent on personal things. (That’s a heck of a wad of discretionary income.)
The clinic owner pleaded guilty to Medicaid fraud and was sentenced to spend next decade of her life on her best behavior (along with a significant lifestyle change). After she serves two years in prison, she’ll be on probation for another eight. She must also repay the government a total of $659,183.
Purposefully targeting Medicaid patients, with the expectation that the government is not paying as much attention as private health insurers, is just not the way to function.
The post Family Dysfunctions appeared first on Fraud of the Day.