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Owner and Employees of Ohio Non-Profit Organization Charged in Scheme to Defraud Medicaid

pexels-photo-48604-300x191The U.S. Attorney’s Office for the Northern District of Ohio announced the return of a 28-count indictment charging the owner of a mental-health nonprofit organization and eight of his employees for their alleged roles in a multi-million dollar scheme to defraud Medicaid.

Named in the indictment are: Alfonzo D. Bailey, 38, of Cleveland, OH; David Brown, 39, of Maple Heights, OH; Valerie White, 51, of Columbus, OH; Sandra Wilson, 52, of Cleveland, OH; Cheria Oliver, 31, of Canal Winchester, OH; Charchee Tucker, 43, of Warrensville Heights, OH; Allen Steel, 38, of Parma, OH; Kamelah Ganaway, 43, Macedonia, OH; and Tremayne Kellom, 41, of Cleveland, OH.  A court docket lists attorneys for only Tucker and Wilson. It is unclear if the other defendants have acquired legal representation.

According to the indictment, Bailey is the owner of Eye For Change Youth & Family Services, Inc., a nonprofit organization based in Cleveland; the other 8 defendants are his employees. Prosecutors are accusing the defendants of falsely billing Medicaid for services that were never performed from February 2017 to September 2020.

The indictment accuses Bailey of paying White and Wilson, who are licensed independent social workers, to use their social worker provider numbers and credentials to bill Medicaid for mental health screenings that were never performed. Bailey, Brown, White, and Wilson also allegedly billed Medicaid for counseling services without putting an appropriate treatment plan in place for clients, as is required by law.

Bailey, Brown, White, and Wilson are further accused of paying kickbacks in the form of cash, rent or bill payments, and gift cards to Medicaid beneficiaries to keep them as clients and bill Medicaid for services Eye For Change never provided. They would also allegedly direct Eye For Change employees to “misdiagnose Medicaid beneficiaries to continue to get authorization from the Ohio Department of Medicaid to provide services and to bill at higher rates,” according to the indictment. Bailey, Brown, Tucker, Oliver, Ganaway, Steele, and Kellom purportedly directed and allowed employees to insert fictitious progress notes into their clients’ electronic records in order to create the fake documents required when submitting Medicaid claims.

“These defendants are accused of defrauding a tax-payer funded health care benefit program that was created to assist some of the most vulnerable among us,” said First Assistant U.S. Attorney Bridget Brennan. “Their alleged conduct, including the payment of kickbacks, was designed simply to enrich themselves. We are grateful for the hard work of the agencies involved who, like us, are dedicated to bringing allegations of fraud and illegal kickbacks before the court.”

As a consequence of the alleged offenses, the defendants are required to forfeit approximately $2.3 million seized during the execution of search warrants at several properties associated with Eye For Change.

“There are actually real people out there who are suffering and need help,” Ohio Attorney General Dave Yost said. “You don’t have to make up imaginary patients. A jury of their peers will undoubtedly know some of them. I’m grateful for the state-federal partnership that is bringing these fakes to justice.”

Medicare fraud is a felony offense and a conviction carries significant criminal and civil liabilities. As such, it is imperative for any healthcare provider accused of falsely filing claims to a government health care program to immediately seek legal assistance.

South Florida Fraud Attorney

Are you accused of committing healthcare fraud in South Florida? Contact Brian Silber, P.A. to set up a free initial consultation with one of South Florida’s most experienced fraud defense attorneys.

Source: 11.12.20 nine charged in scheme to defraud medicaid.pdf

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