03 October 2013

4 PEOPLE CONNECTED TO ADULT WELL-BEING SERVICES CHARGED IN MEDICAID FRAUD SCHEME


Story First Appeared in  Crain's Detroit Business.

Michigan Attorney General Bill Schuette has filed felony charges against four employees and former employees of Detroit-based mental health care provider Adult Well-Being Services for their alleged roles in a Medicaid fraud scheme.

The attorney general filed charges on Sept. 25 in the 54B District Court in East Lansing against:

• Current employee Dr. Sandra Schiff, PhD, 66, of West Bloomfield.

• Current employee William Vallier, 65, of Clawson.

• Former employee Marceia Lugo, 39, of Sterling Heights.

• Former employee Laura Leca, 27, of Westland.

The charges allege that in March 2011, a healthcare provider left her employment at Adult Well-Being without completing progress notes for hundreds of meetings with mental health patients.

The incomplete patient records violated Medicaid program rules, and a scheduled audit of the agency would have revealed that and triggered a repayment demand to Adult Well-Being, the attorney general said in a release.

He alleges that the four employees forged the electronic signature of the former employee more than 10 months after her departure, without her knowledge or consent, to create and authenticate false progress notes.

The former employee whose signature was allegedly forged by the four defendants does not face criminal charges at this time, but the investigation continues, the attorney general said. The U.S. Department of Health and Human Services – Office of Inspector General is assisting in the investigation.

The charges stem from a June 2012 raid of Adult Well-Being Services locations.

The four defendants are each charged with:

• One count of Medicaid fraud- false record or statement to avoid payment to the state, a felony punishable by four years in prison and/or a $50,000 fine.

• One count of medical records- intentionally placing false information on chart-health care provider, a felony punishable by four years in prison and/or a $5,000 fine.

The four defendants surrendered themselves to authorities and were arraigned on Sept. 26 before Judge Andrea Larkin, who set personal bond for each at $25,000.

A preliminary exam of the defendants is set for Wednesday.

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