The Stigma of Fraud


People who struggle with mental health issues not only have to deal with the symptoms and disabilities that come along with the diagnosis, but also with the stigma that is placed upon them by society. Even though there are a wide variety of treatment programs available to help mental health patients deal with the symptoms, disabilities and social labels, there are some unprofessional mental health professionals that take advantage of the disadvantaged. The Department of Justice reports that a former licensed mental health counselor in Florida took advantage of many of his mental health patients and billed Medicare for approximately $63 million for services that were not provided.

The press release reports that a 50-year-old former licensed mental health counselor, who worked at a mental health facility that claimed to provide Partial Hospitalization Program (PHP) services, was aware that personnel at two center locations were routinely fabricating notes for patient records. (A PHP is a combination of in-patient and out-patient treatment for severe mental illness.) These false records, which were created weeks and months after the patients had been admitted to the treatment facilities, were used to file fraudulent bills with Medicare and Florida Medicaid over a period of approximately seven years.

The Miami resident pleaded guilty to one count of conspiracy to commit health care fraud. He is facing a maximum sentence of 10 years.

It looks like this fraudster is going to learn an important lesson in empathy while serving out his prison term. Even after his jail time is over, this former counselor may need some therapy of his own to deal with the stigma of being a criminal.

Source: Today’s ”Fraud of the Day” is based on a press release titled, ”Therapist Pleads Guilty in Miami for His Role in $63 Million Health Care Fraud Scheme,” released by the Department of Justice on December 12, 2013.

WASHINGTON – A former licensed mental health counselor at the defunct health provider Health Care Solutions Network Inc. (HCSN) pleaded guilty today in Fort Lauderdale, Fla., for his role in a $63 million health care fraud scheme.

Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division, U.S. Attorney Wifredo A. Ferrer of the Southern District of Florida, Special Agent in Charge Michael B. Steinbach of the FBI’s Miami Field Office; and Special Agent in Charge Christopher B. Dennis of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) Office of Investigations Miami Office made the announcement.

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Larry Benson
Larry Benson is currently the Director of Strategic Alliances for Revenue Discovery and Recovery at LexisNexis Risk Solutions. In this role, Benson is responsible for developing partnerships for the tax and revenue and child support enforcement verticals. He focuses on embedded companies that have a need for third-party analytics to enhance their current offerings.