Medical Business Owner Indicted for Medicaid Fraud
Business Provided Speech-Language Therapy Services for Children
|U.S. Attorney’s Office June 18, 2013|
ATLANTA—Jennifer C. Alsdorf has been indicted on charges of health care fraud and wire fraud for filing over $500,000 in fraudulent claims with the Georgia Medicaid program.
“This defendant is charged with robbing Medicaid of over half-a-million dollars intended for children in need. Her alleged fraud includes billing for medical services never performed, for patients never seen, and in the names of medical professionals who were not working for the defendant,” United States Attorney Sally Quillian Yates. “Medicaid fraud affects individuals, families, and communities in higher costs, and, as this case shows, we have a strong federal-state alliance intent on combating this serious crime.”
“The FBI continues to work hard in ensuring that federal Medicaid funds are used in the manner intended by law and will continue to work with its various law enforcement partners in identifying, investigating, and presenting for prosecution those individuals who abuse the system,” stated Mark F. Giuliano, Special Agent in Charge, FBI Atlanta Field Office. “Anyone with information regarding health care fraud should contact their nearest FBI field office immediately.”
“It appears that Ms. Alsdorf viewed Medicaid as a slush fund to enrich herself,” said Attorney General Sam Olens. “This case sends a strong message that the federal and state governments will work together to aggressively prosecute Medicaid fraud in Georgia.”
According to United States Attorney Yates, the charges, and other information presented in court: Jennifer C. Alsdorf, 43, of Tampa, Florida, is the owner, president, and CEO of Hand in Hand Speech & Language Services Inc. The medical business is located in Tampa, Florida (and prior to 2005 in Vidalia, Georgia) and offers speech-language therapy services for children covered by Medicaid. Acting on behalf of Hand in Hand, Alsdorf contracted with speech-language pathologists to perform services under independent contractor agreements. Alsdorf would bill Medicaid for the services provided by the pathologists and then send a portion of the amount she received from Medicaid to them.
In the contracts, Alsdorf agreed to pay a set fee to the pathologists for each initial evaluation and each subsequent therapy visit rendered by the pathologists to Medicaid recipients. The fees that Alsdorf paid to the pathologists for those two services were less than, but based on, the amounts that Medicaid reimbursed for the services. Alsdorf made a profit by keeping the difference between what Medicaid paid and what she remitted to the pathologists.
After rendering services to patients, the pathologists would send Alsdorf treatment notes showing which patients they had seen, how long they had provided therapy, and which services they had provided. Alsdorf was supposed to use these notes to prepare the claims to submit to Medicaid. Unbeknownst to the speech-language pathologists, however, in addition to billing Medicaid for initial evaluations and therapy visits, Alsdorf also billed Medicaid for “sensory integration” therapy, a service the pathologists had not provided. Many of the pathologists did not even know what sensory integration therapy was and had never heard of such a service. Alsdorf did not send any of the money she received from Medicaid for this service to the pathologists. She instead kept all the money she received for sensory integration therapy.
Alsdorf also submitted claims to Medicaid for patient visits that never occurred. She submitted claims under pathologists’ names for services during times when they were not working with Hand in Hand. She also submitted claims representing that the pathologists had treated certain patients when, in fact, the pathologists had never seen or treated the patients at any time. Alsdorf is alleged to have submitted over $500,000 in fraudulent claims to Medicaid.
A federal grand jury indicted the defendant on May 21, 2013, who was arraigned today on the charges before United States Magistrate Judge Justin S. Anand.
The indictment charges 74 counts of health care fraud and 10 counts of wire fraud. Each health care fraud count carries a maximum sentence of 10 years in prison, and each wire fraud count carries a maximum sentence of 20 years in prison. Each count also carries a fine of up to $250,000. In determining the actual sentence, the court will consider the United States Sentencing Guidelines, which are not binding but provide appropriate sentencing ranges for most offenders.
Members of the public are reminded that the indictment contains only allegations. The defendant is presumed innocent of the charges, and it will be the government’s burden to prove the defendant’s guilt beyond a reasonable doubt at trial.
This case is being investigated by special agents of the Federal Bureau of Investigation and Investigators from the Georgia Medicaid Fraud Control Unit and the Georgia Department of Community Health.
Assistant United States Attorney Stephen H. McClain and Georgia Assistant Attorney General Henry A. Hibbert are prosecuting the case.
For further information please contact the U.S. Attorney’s Public Information Office at USAGAN.Pressemails@usdoj.gov or (404) 581-6016. The Internet address for the U.S. Attorney’s Office for the Northern District of Georgia is www.justice.gov/usao/gan.