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Healthcare-Medicare-6
Senior Director of Strategic Alliances
LexisNexis Risk Solutions - Government

Erica Goodley and Billy Kirby, the owners of two Las Vegas, Nev., behavioral health clinics pleaded guilty to one count of conspiracy to commit health care fraud and one count of health care fraud after defrauding the Medicaid health care benefit program. Goodley and Kirby, originally from Georgia, were the owners of Endeavor Behavioral Health and International Behavioral Health. (Somebody might want to let them know that it’s their behavior that seems to be in question here.)

The two behavior health clinic owners conspired to provide false representations and omitted Kirby’s 2005 gross misdemeanor conviction on applications to enroll their clinics as medical providers with Medicaid. (Just a small omission, right?)

Between June 2016 and February 2018, their clinics fraudulently billed Nevada Medicaid for 24 hours of counseling services by a single provider in one day and for counselors who either did not exist or weren’t currently working for the clinics. (I wouldn’t recommend going to one of these clinics if you’re looking to improve your mental health.)

Through their scheme, Goodley and Kirby received $499,440.70 in fraudulent Medicaid benefits. The two owners were sentenced to three years of probation and must pay restitution in the amount of $499.400.70. (An easily deserved sentence given that those government funds could have gone to those who needed it.)

Today’s Fraud of the day comes from a Fox 5 Las Vegas article, “Owners of 2 Las Vegas behavioral health clinics sentenced for Medicaid fraud,” published on April 22, 2022.

LAS VEGAS – Two Las Vegas behavioral health clinic owners were sentenced to three years of probation and ordered to pay $499.400.70 in restitution after receiving fraudulent Medicaid benefits through fraudulently billed services.

Erica Goodley and Billy Kirby of Georgia pleaded guilty in January 2022 to one count of conspiracy to commit health care fraud and one count of health care fraud. In addition to probation, U.S. District Judge Andrew P. Gordon ordered the defendants to forfeit $499,440.70, according to a United States Attorney press release.

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