Thursday, May 2, 2013

$63 Million Verdict for Mental Health, False Claims Scheme


$63 Million Verdict for Mental Health, False Claims Scheme

The Department of Justice reported yesterday that the supervisor of a $63 million health care fraud scheme has been convicted. 51-year-old Wondera Eason, supervisor of a Miami-area mental health care company, Health Care Solutions Network (HCSN), was found guilty of conspiracy to commit health care fraud. She was employed as Director of Medical records at HCSN’s Partial Hospitalization Program (PHP), an intensive treatment facility for patients with severe mental illness.
Eason, a certified medical records technician, oversaw the “alteration, fabrication, and forgery of thousands of documents, which purported to support the fraudulent claims HCSN submitted to Medicare and Florida Medicaid.” She reportedly directed therapists to fabricate documents as well, and provided Medicare and Medicaid auditors with fraudulent documents, which she certified were accurate.
Oftentimes, HCSN “therapy” consisted of “nothing more than patients watching Disney movies, playing bingo, and having barbeques.” Eason purportedly told therapists to eliminate any references to these activities from their medical records.
Evidence at trial showed that HCSN paid illegal kickbacks to owners and operators of Miami-Dade County Assisted Living Facilities (ALF) in exchange for patient referral information, which was used to submit fraudulent claims to Medicare and Medicaid. It was found that HCSN billed an estimated $63 million to Florida Medicare and Medicaid from 2004 to 2011.
The previous owner of HCSN, which operated in two locations in Florida, opened a third facility in Hendersonville, North Carolina after stealing millions from Medicare and Medicaid in Florida. In February, Armando Gonzalez pled guilty to health care fraud and money laundering charges, and was sentenced to fourteen years in prison plus three years supervised release, and ordered to pay $28,092,283 in restitution.
Alisha Mims is a writer and researcher for Ring of Fire. 

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