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A Story of Medicaid Fraud

A Story of Medicaid Fraud

Healthcare-7
Senior Director of Strategic Alliances
LexisNexis Risk Solutions - Government

Once upon a time, there was a woman named Elizabeth Storey, who owned and operated North Florida Mental Health (NFMH), a counseling center in Tallahassee, Fla. She employed a woman named Stephanie Lynn Fleming, who was a licensed mental health counselor. Together, these two women were found guilty of health care fraud conspiracy, health care fraud, and aggravated identity theft. Fleming was also found guilty of making false statements in connection with health care matters. (Let’s just say that if you are a fan of stories that end with justice being served, then this tale is for you. The good guys win.)

Storey’s story includes hiring Fleming, who provided psychotherapy, psychiatric diagnostic evaluations, and therapeutic behavioral services to patients of NFMH. Fleming’s story includes agreeing to a five-year debarment from participating in any state Medicaid program due to a 2016 felony conviction involving Medicaid fraud in the state of New Jersey.

It’s important to note that Fleming falsely claimed she had not been convicted of, or pled guilty or no contest to, a felony when she filled out an application to become a Florida Medicaid provider. (Despite this disturbing information, Storey hired her anyway and their story became even more complicated because she knew all about Fleming’s prior conviction and debarment.

During a three-day trial, evidence was presented showing that Storey and Fleming improperly obtained, or attempted to obtain, more than $250,000 from Florida Medicaid. They submitted fraudulent bills through NFMH, ignoring that fact that Fleming was ineligible to participate as a Medicaid provider. (They even committed identity theft to increase the mental health practice’s profits.)

These bills erroneously reflected that another NFMH therapist, who was eligible and licensed, performed the services that were billed. (That was not true. Fleming provided those services while being debarred from participating in any state Medicaid program, nationwide.) And, then there were instances where the names and personal identification information of other NFMH patients were used to submit false Medicare claims for services that were never performed.

NFMH owner and operator Elizabeth Storey’s story take a sad turn at this point in the tale. She was sentenced to two years and one day in prison followed by three years of supervised release. Fleming’s tale of woe gets even more woeful as she was sentenced to three years and one day in prison followed by three years of supervised release. They were both ordered to pay $219,000 in restitution to the Florida Agency for Healthcare Administration (AHCA) for committing Medicaid fraud. (While these two suffered a demise that could be expected for committing such a crime, in the end justice prevailed. You could say that is a happy ending indeed for all Medicaid beneficiaries.) The End.

Today’s Fraud of the Day comes from a Department of Justice press release, “Florida Counseling Center Owner And Provider Sentenced To Federal Prison For Medicaid Fraud, Conspiracy, False Statements, And Identity Theft,” dated November 19, 2021. 

TALLAHASSEE, FLORIDA – Jason R. Coody, Acting United States Attorney for the Northern District of Florida announced the sentencings of Stephanie Lynn Fleming, 43, and Helen Elizabeth Storey, 39, both of Waldorf, Maryland, and both formerly of Tallahassee, Florida. Fleming was sentenced to a total of three years and one day in prison followed by three years of supervised release. Storey was sentenced to a total of two years and one day in prison followed by three years of supervised release. Both defendants were ordered to pay $219,000 in restitution to the Florida Agency for Healthcare Administration (AHCA).

Fleming’s and Storey’s sentences were the result of a 3-day federal bench trial resulting in guilty verdicts for most counts on April 6, 2021. Both defendants were found guilty of health care fraud conspiracy, health care fraud, and aggravated identity theft. Fleming was also found guilty of making false statements in connection with health care matters.

 

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