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Circumvent The Way To Fraud

Circumvent The Way To Fraud

Medicaid
Senior Director of Strategic Alliances
LexisNexis Risk Solutions - Government

Thelma “Wendy” Epps was a Licensed Alcohol and Drug Abuse Counselor (LADC) enrolled as a participating provider in the Connecticut Medicaid program for her practice Miracles To Destiny LLC. In July 2018, the Medicaid program suspended Epps from participating in the program with a warning that any attempt to circumvent her suspension by submitting claims for services performed by herself, or through other agencies or other billing numbers, would result in termination of her provider agreement. But if fraudsters are great at breaking rules, they are even better at dodging warnings. And Epp’s dodged the Department of Health and Human Services’ warnings with two schemes.

In 2019, Epps made an agreement with colleague Dennis Tomczak to use his Medicaid provider number for psychotherapy counseling services purportedly provided by Epps. In exchange for Tomczak billing Medicaid as the provider of the services, Epps paid him 25% percent of the monies fraudulently received. While Tomczak had voiced concerns about the number and frequency of services that Epps insisted she was providing, it didn’t stop him from filing over a million dollars in fraudulent Medicaid claims.

At about this time, Epps made an agreement with another colleague, Shawn Tyson. Epps actually assisted Tyson with the process of enrolling him as a participating provider in Medicaid, using her Miracles to Destiny practice address. Once Tyson was enrolled, Tyson provided Epps with his login information to the online portal for submitting claims to Medicaid. Epps fraudulently submitted hundreds of claims to Medicaid for services that neither she nor Tyson provided.

On February 4, 2025, Thelma “Wendy” Epps, 60, was sentenced to two years and three months in prison. Should have heeded the warning from HHS.

Great job by the Department of Health and Human Services in this case.

Today’s Fraud of The Day is based on article “Former Hartford substance abuse counselor sentenced for health care fraud schemes” published by Fox 61 News on February 4, 2025.

Hartford woman who previously worked as a substance abuse counselor in the city was sentenced in Bridgeport last Friday to two years and three months in prison for committing health care fraud. Thelma “Wendy” Epps, 60, must also pay $1,001,058 in restitution to the Connecticut Medicaid program, according to the Office of the U.S. Attorney for the District of Connecticut.

Epps’ prison sentence will be followed by three years of supervised release. Court documents and statements revealed that Epps was a Licensed Alcohol and Drug Abuse Counselor, or LADC, with a third-floor office on Main Street in Hartford. She enrolled as a participating provider in the Connecticut Medicaid program in April 2013 along with an entity called “Miracles to Destiny, LLC” that she was affiliated with.

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