{"id":23504,"date":"2016-05-19T09:58:36","date_gmt":"2016-05-19T16:58:36","guid":{"rendered":"https:\/\/cjnotebook.com\/?p=23504"},"modified":"2016-05-19T09:58:36","modified_gmt":"2016-05-19T16:58:36","slug":"counselors-sentenced-9-5-million-fraudulent-billing-scheme-far-nearly-30-defendants-including-doctors-convicted","status":"publish","type":"post","link":"https:\/\/cjnotebook.com\/?p=23504","title":{"rendered":"Counselors Sentenced for $9.5 Million Fraudulent Billing Scheme; So far, Nearly 30 Defendants Including Doctors, Convicted"},"content":{"rendered":"

\"USDALLAS<\/span><\/strong><\/span><\/p>\n

\n

Two counselors from the Dallas-Fort Worth plead guilty for their involvement in a massive health care fraud scheme.<\/span><\/p>\n

The scam involved bribes, unnecessary medical treatment, fraudulent billing, and the falsification of medical documents\u00a0to fraudulently bill the federal government, through the Department of Labor\u2019s \u00a0Office of Worker Compensation Programs, of more than $9.5 million.<\/span><\/p>\n

The lead defendant charged in the case, licensed professional counselor Larry Washington<\/strong>, 63, of Desoto, Texas, was sentenced on Monday to 78 months in federal prison and ordered to pay approximately $7.7 million in restitution.<\/span><\/p>\n

He plead guilty in January 2016 to one count of conspiracy to commit health care fraud and must surrender to the Bureau of Prisons on July 19, 2016.\u00a0 Washington ran businesses known as AAA Mental Health, LLC, Mind Spa, Inc., Solutions Health and Rehabilitation, and Convergence Emergence Diversion.<\/span><\/p>\n

Another licensed professional counselor, Henrietta Price,<\/strong> 51, of Cedar Hill, Texas, was sentenced on Monday to six months home confinement, three years of probation and was ordered to pay $199,796.93 in restitution.<\/span><\/p>\n

She also plead guilty to one count of conspiracy to commit health care fraud.<\/span><\/p>\n

Price provided counseling services at Mind Spa, Inc. and also treated patients at her own company, Lifeline Counseling, according to officials.<\/span><\/p>\n

Through his businesses, officials said Washington provided patients with counseling, pain management, chiropractic services, physical therapy and massage services.\u00a0 He sought out and recruited his patients who were former postal and VA employees who had suffered on-the-job injuries that prevented them from returning to work.<\/span><\/p>\n

Washington knew that even though these individuals had once suffered a work-related injury, their injuries were not severe enough to warrant continued Worker’s Compensation payments.<\/span><\/p>\n

Twenty-one claimants, four doctors or medical providers, a senior claims examiner at Department of Labor, a claims representative, and a medical provider\u2019s employee were charged in the scheme.<\/span><\/p>\n

All but two defendants have pleaded guilty to their respective roles in the scheme.<\/span><\/p>\n

In total, the defendants were able to collectively fraudulently bill the federal government through the Workers Compensation for more than $9.5 million and receive more than $8.7 million in government payments based on their fraudulent billing.<\/span><\/p>\n

The Department of Labor made about $11.4 million in payments to these claimants for their compensation and medical services.<\/span><\/p>\n

The government anticipates that as a result of the convictions, it will also prevent the payment of an estimated $11 million in future payments to the claimant defendants.<\/span><\/p>\n

The Scheme Began with Federal Workers<\/strong><\/p>\n

The scheme began with former or current government employees \u2013 U.S. postal employees or Veterans Affairs (VA) employees \u2013 who claimed that they had been injured during the course of their work duties, according to authorities.<\/span><\/p>\n

Each of these claimants claimed they had suffered an on-the-job injury, ranging from strains to trigeminal neuralgia, which prevented them from returning from work.<\/span><\/p>\n

Under Workers Compensation, these \u201cclaimants\u201d could receive workers\u2019 compensation payments (typically between 66% and 75% of pre-disability wages, tax free) and paid medical treatment, if a qualified doctor deemed the medical services necessary to treat the injury and if the injury prevented the claimant from working.<\/span><\/p>\n

A Department of Labor claims examiner would review the claim and its documentation, and either approve or reject the claim.<\/span><\/p>\n

In certain circumstances, if an on-the-job injury caused permanent damage, a claimant could have received a \u201cscheduled award\u201d \u2013 that is, a lump sum payment meant to compensate that individual for their injury, according to officials.<\/span><\/p>\n

These awards often amounted to several hundred thousand dollars.\u00a0 Claimants often sought the help of professionals, typically former Department of Labor claims examiners in filing their claims and in getting their claims approved.<\/span><\/p>\n

These \u201cclaims representatives\u201d either charged claimants a percentage of any paid claim or a flat rate fee.<\/span><\/p>\n

When doctors or other medical providers treated the claimants, they could bill Workers Compensation for their work if they submitted the proper documentation and certification.<\/span><\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

Two counselors from the Dallas-Fort Worth plead guilty for their involvement in a massive health care fraud scheme.
\nThe scam involved bribes, unnecessary medical treatment, fraudulent billing, and the falsification of medical documents to fraudulently bill the federal government, through the Department of Labor\u2019s Office of Worker Compensation Programs, of more than $9.5 million.<\/p>\n","protected":false},"author":1,"featured_media":17707,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[16,3],"tags":[1609,2647,2646],"class_list":["post-23504","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-home-main-slider","category-u-s-department-of-justice","tag-department-of-labor","tag-larry-washington","tag-workers-compensation"],"yoast_head":"\nCounselors Sentenced for $9.5 Million Fraudulent Billing Scheme; So far, Nearly 30 Defendants Including Doctors, Convicted<\/title>\n<meta name=\"description\" content=\"Two counselors from the Dallas-Fort Worth plead guilty for their involvement in a massive health care fraud scheme. 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