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It's a Numbers Game

Healthcare-Medicare-10
Senior Director of Strategic Alliances
LexisNexis Risk Solutions - Government

Medicaid fraud is common, and unfortunately more people than you would expect are convicted of participating in such crimes. In March 2022, Courtney Dunlap of Burlington, Conn., was sentenced to 57 months in prison, followed by three years of supervised release, for defrauding the Connecticut Medicaid Program of more than $1.3 million. (Well, that’s one way to become a millionaire, temporarily at least.)

Dunlap was a Licensed Professional Counselor (LPC) in Hartford from 2014 – 2020. He also owned Inspirational Care and KEYS Program Inc., through which he managed group homes across the state. He assisted women and children domestic abuse victims.

From August 2018 through October 2020 the former LPC conducted a fraudulent billing scheme. (“Former” being the key word here.) It involved submitting false claims of psychotherapy services that were allegedly provided to his Medicaid clients. Dunlap billed Medicaid for psychotherapy services through Inspiration Care, despite the fact these services were not provided.

Dunlap utilized the provider number of a clinical social worker who was unaware her personal credential was being used to bill for nonexistent services. He required the tenants of the group homes operated or managed by the two entities he owned to provide copies of their Medicaid member cards. He then used the Medicaid member identification number of approximately 65 tenants or their children to bill Medicaid for over $500,000 in fraudulent psychotherapy services that had not been provided. (Nothing shows a person’s character quite like taking advantage of domestic abuse victims.)

However, this is not where Dunlap’s scheme ended. New Haven Public Schools hired him as a guidance counselor at the New Haven Adult and Continuing Education Center in February 2019. One year after his hiring, Dunlap accessed a work database to determine which students had Medicaid insurance and then acquired said students’ Medicaid member identification numbers. Dunlap then proceeded to bill Medicaid for fraudulent psychotherapy services that were not provided to the students, many of whom he had no professional relationship with and had never met. He submitted claims for approximately 135 New Haven Adult and Continuing Education students and was paid close to $600,000 from the fraudulent claims. (Why stop at taking advantage of at-risk individuals when you can also take advantage of students in your workplace?)

Dunlap’s fraud did not stop here, either. He also falsified bills for psychotherapy services that were never provided to both his employees and his own family. (Students, family, employees… clearly Dunlap has zero loyalty, nor any ethics.) Ultimately, the Connecticut Medicaid program suspended Dunlap as a medical provider. He was arrested on a criminal complaint, and he subsequently pleaded guilty to one count of healthcare fraud. In addition to Dunlap’s sentencing of 57 months in prison and three years of supervised release, he must also pay just over $1.3 million in restitution to Medicaid, $543,129.17 of which is still outstanding.

Today’s Fraud of the Day comes from a Department of Justice press release “Counselor Sentenced to Federal Prison for Wide-Ranging Medicaid Fraud Scheme,” on March 11, 2022.

Leonard C Boyle, United States Attorney for the District of Connecticut, announced that CORTNEY DUNLAP, 37, of Burlington, was sentenced today by U.S. District Judge Kari A. Dooley in Bridgeport to 57 months of imprisonment, followed by three years of supervised release, for operating a wide-ranging scheme that defrauded the Connecticut Medicaid Program of more than $1.3 million.

According to court documents and statements in court, from 2014 to 2020, Dunlap was a Licensed Professional Counselor with offices located on Brainard Road in Hartford.  Dunlap also owned two entities, Inspirational Care and KEYS Program Inc., through which he managed group homes in Hartford, Bristol, Cromwell and Waterbury, including residences for women and children who were victims of domestic abuse.

 

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