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Stuck with the Bill

Healthcare-8
Senior Director of Strategic Alliances
LexisNexis Risk Solutions - Government

Group homes provide a place where a small number of unrelated individuals, who need care, support, or supervision, can live together while receiving assistance. Those support services can include help with cooking, cleaning, shopping, personal care, mental health counseling services, financial management, personal relationships, and community connections.

A former manager of multiple group homes in Hartford, Bristol, Cromwell, and Waterbury, Conn., took advantage of his position and spearheaded a healthcare fraud scheme that stole more than $1.3 million from the Connecticut Medicaid Program. (So much for helping vulnerable individuals. This guy robbed his victims of benefits they deserved.)

Cortney Dunlap, 37, of Burlington, Conn., owned Inspirational Care and KEYS Program Inc., through which he managed the group homes. He reportedly required tenants of the group homes to provide copies of Medicaid member numbers before allowing them to become a resident at any of the group homes. (He was setting up the pipeline for his fraud scheme with a steady stream of victims.)

For more than two years, Dunlap, who was also a licensed professional counselor, used the Medicaid beneficiary numbers of around 65 tenants and their children to bill Medicaid for fraudulent services purportedly received at the group homes. But most of these services were not rendered. (In the few cases where services were provided, unlicensed individuals provided the psychotherapy.) He illegally received approximately $543,117 from Medicaid for those claims. Dunlap was suspended as a provider in April 2020 by Medicaid, and federal law enforcement agents performed a search of his Hartford offices the following month.

But the plot thickens. Just a year earlier, he accessed a database through the New Haven Adult and Continuing Education Center, where he served as a guidance counselor. (The only guiding he did was making sure those government benefits got funneled into his bank accounts.) The database contained the personal information, such as Medicaid beneficiary numbers, of current students and former students at the center. He used the member numbers of about 135 students to submit fraudulent claims for psychotherapy services. He illegally billed Medicaid for $593,383.

And, if that were not enough, Dunlap also fraudulently billed Medicaid for services he claimed were provided to employees at Inspirational Care. He also billed Medicaid for purported services provided to his own family. (Apparently, he was just going for anyone and everyone.)

Dunlap pleaded guilty to healthcare fraud and was sentenced to 57 months in prison to be followed by three years of supervised release for committing Medicaid fraud. He was also ordered to pay restitution of $1,313,322 to Medicaid.

Fortunately, Medicaid was able to recover $337,777.63 in payments that Dunlap was set to receive. The US Attorney’s Office’s Civil Division also seized and forfeited $412,415.20 from his bank accounts. While Dunlap did make a restitution payment of $20,000, he still owes another $543,129.17. He reports to prison (his new group home) on April 25, 2022. (Perhaps he’ll be able to receive some badly needed psychotherapy services while behind bars. Once again, the Federal Government and American taxpayers will get stuck with the bill.)

Today’s Fraud of the Day comes from an article, “Hartford County Man Sentenced For Wide-Ranging $1.3M Medicaid Fraud Scheme,” published by Hartford Daily Voice on March 13, 2022.

A former licensed professional counselor was sentenced for operating a scheme to defraud the Connecticut Medicaid Program of more than $1.3 million.

Hartford County resident Cortney Dunlap, age 37, of Burlington, was sentenced on Friday, March 11, to 57 months in prison followed by three years of supervised release, according to Leonard Boyle, United States Attorney for the District of Connecticut.

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