8 recent behavioral health billing fraud cases

Here are eight recent cases of billing fraud and alleged billing fraud involving behavioral health providers Becker's has reported since Sept. 12: 

  1. The ex-wife of a Texas therapist was sentenced to serve 54 months in prison for defrauding Medicaid of more than $600,000. Kay Le Farmer, who was the office manager for her former husband's therapy practice, pleaded guilty to fraud earlier this year.

  2. A Rhode Island social worker pleaded guilty to orchestrating a billing fraud scheme that cost Medicare, Medicaid and private insurers $3.5 million. According to the Justice Department, Mi Ok Song Bruining was a supervisor at Recovery Connections Centers of America in Providence, R.I. Ms. Bruning admitted she and other employees she supervised routinely submitted false claims, billing for more psychotherapy appointments than could be completed in a day.

  3. Brockton, Mass.-based Luminosity Behavioral Health has agreed to pay $700,000 to resolve allegations of fraud. The settlement follows an investigation from the Massachusetts attorney general's office, which alleged Luminosity submitted claims to MassHealth and MassHealth managed care entities by using billing codes that overstated the scope of services it provided to MassHealth members and inflated the amount of payment claimed for its services.

  4. A Virginia behavioral health services provider and its owner will pay $918,000 to settle allegations it submitted false claims to Medicaid and Tricare. According to the Justice Department, a whistleblower lawsuit alleged the practice and owner Bianca Riddle submitted claims for applied behavioral analysis services that were not provided. Connex provided behavioral analysis services to children with autism spectrum disorder.

  5. A Georgia behavioral health counselor will serve six months in prison and 4.5 years on probation for submitting false claims to the state's Medicaid program. 
  1. A Minnesota psychologist was sentenced to two years in prison for fraudulently billing Blue Cross Blue Shield of Minnesota and the Shakopee Mdewakanton Sioux Community for over $800,000.

  2. A Charlotte, N.C.-based behavioral health services provider was indicted on federal charges for allegedly defrauding South Carolina's Medicaid program and falsely obtaining COVID-19 relief funds. 

  3. A Colorado psychiatry practice agreed to pay $1.9 million to settle allegations that it knowingly double billed time to receive increased Medicare and Medicaid payments. 

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