Summer Matteson and Terrence Ewing were co -managers of Laynie Foundation. A part time mental health counseling provider for the youth and full-time cloak for fraud. Matteson and Ewing, along with foundation employee Richard Grundy fraudulently billed Illinois Medicaid for more mental health counseling services than the foundation actually provided. Not only that, Matteson, Ewing and Grundy also used Laynie Foundation to seek payment for non-reimbursable activities, such as internal case reviews, staff training, clinical supervision, and recordkeeping. Basically, anything that didn’t require face to face interaction with kids! These fraudsters were not interning for Mary Poppins after all.
Matheson attempted to cover up the fraud by directing foundation personnel to backdate and falsify patient records to make it appear that a licensed practitioner had reviewed and approved certain mental health services. But in fact, there was no practitioner reviewing the paperwork and Matheson knew it. Because she was approving the claims too.
As a result, Matheson, Ewing, and Grundy fraudulently obtained between 2011 to 2018 approximately $2.5 million in Medicaid claims. At $75 per billable hour provided by a therapist (an estimate for Fraud of The Day purposes), that is, give or take, about thirty-three thousand hours of therapy not given to children who need it the most. Therefore, letting down kids who are already down.
Matheson, Ewing, and Grundy each pleaded guilty last year to a federal health care fraud charge. On September 17, 2024, U.S. District Judge John Robert Blakey sentenced Matheson to six years in federal prison, and Ewing to four and a half years. Judge Blakey previously sentenced Grundy to three years and a month.
Excellent job by the Department of Health and Human Services.
Today’s Fraud of The Day is based on article “Suburban Chicago youth center owners sentenced to prison for Medicaid billing scam” published by Fox 32 Chicago News on September 17, 2024.
The co-managers of a youth counseling center in Matteson have been sentenced to prison for defrauding Illinois Medicaid out of $2.5 million. From 2011 to 2018, Summer Matheson and Terrence Ewing, along with an employee, Richard Grundy, used Laynie Foundation Inc. to bill Illinois Medicaid for mental health counseling services that were never provided.
The foundation also sought reimbursement for activities not covered by Medicaid, including internal case reviews, staff training, clinical supervision, and recordkeeping. Matheson tried hiding the fraudulent activities by telling foundation personnel to backdate and falsify patient records to make it seem like a licensed practitioner had reviewed and approved the services.
