Industry News

Health Care Medical Director and Therapists Arrested in $63 Million Fraud Scheme.

Jennifer Kirchner | July 2013

A health care medical director and six therapists for Health Care Solutions Network (HCSN) in Florida were arrested for conspiring to fraudulently bill Medicare and Florida Medicaid more than $63 million.  The indictment for all accused conspirators seeks forfeiture of proceeds from the alleged healthcare fraud offenses. 

The HCSN providers purported to provide intensive mental health treatment to Medicare and Medicaid beneficiaries for mental health services that were not medically necessary and often not provided, from approximately 2004 to 2011.  HCSN is also alleged to have paid kickbacks to assisted living facility owners and operators who referred beneficiaries to HCSN.  

The medical director of HCSN was sentenced on July 25, 2013 to 135 months in prison and ordered to pay $24.1 million in restitution.

The Department of Justice press release related to the arrests is available at:

http://www.justice.gov/opa/pr/2013/July/13-crm-795.html.

The Department of Justice press release related to the sentencing of HCSN’s medical director is available at:

http://www.justice.gov/opa/pr/2013/July/13-crm-844.html.

Department of Justice.  “Health Care Clinic Director Sentenced for Role in $63 Million Health Care Fraud Scheme.”  Justice News.  25 Jul. 2013.

Department of Justice.  “Florida Health Care Medical Director and Six Therapists Arrested for Alleged Roles in $63 Million Fraud Scheme.”  Justice News.  16 Jul. 2013.

About the Author

Jennifer Kirchner is a licensed attorney in Illinois and Wisconsin. Ms. Kirchner has expertise in assessing provider compliance with the Anti-Kickback Statute, Stark Law, the False Claims Act, HIPAA Privacy and Security Rules and clinical research laws and regulations.