Medical Business Owner Pleads Guilty to Medicaid Fraud
|U.S. Attorney’s Office October 28, 2013|
ATLANTA—Jennifer C. Alsdorf has pleaded guilty to health care fraud for filing fraudulent claims with the Georgia Medicaid program.
“This defendant cheated the Medicaid program by sending in thousands of fraudulent claims for medical services that were never performed,” said United States Attorney Sally Quillian Yates. “We will continue to partner with the Georgia Attorney General’s Office in fighting the costly effects of health care fraud in this state.”
Mark F. Giuliano, Special Agent in Charge, FBI Atlanta Field Office, stated, “Individuals who engage in extensive schemes to defraud health care fraud and compromise our publicly funded programs such as Medicare and Medicaid need to be identified and held accountable. With today’s plea, Ms. Alsdorf will be held accountable for her criminal actions.”
“Fighting Medicaid fraud is a top priority for my office,” said Attorney General Sam Olens. “This case sends a strong message that we take every complaint received seriously, and we will aggressively investigate and prosecute those who overbill Medicaid.”
According to United States Attorney Yates, the charges, and other information presented in court: Jennifer C. Alsdorf was the owner, president, and CEO of Hand in Hand Speech & Language Services Inc. The medical business was located in Tampa, Florida (and prior to 2005, in Vidalia, Georgia) and offered speech-language therapy services for children covered by Medicaid. Acting on behalf of Hand in Hand, Alsdorf contracted with speech-language pathologists to perform the 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 based on the amounts that Medicaid reimbursed for the services.
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 submitted thousands of fraudulent claims to Medicaid.
Alsdorf pleaded guilty to one count of health care fraud. The charge carries a maximum sentence of 10 years in prison and 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.
As part of the plea agreement, Alsdorf has agreed to a restitution judgment of $200,000 to the Georgia Medicaid program, which includes forfeiture of a 2013 Mercedes Benz, thousands of dollars that were previously seized from two retirement accounts and a bank account, and two pieces of real estate located in Montgomery County, Georgia.
Sentencing for Alsdorf, 44, of Tampa, Florida, is scheduled for January 8, 2014, at 10:30 a.m. before United States District Judge Amy Totenberg.
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 Attorneys Stephen H. McClain and G. Jeffrey Viscomi and Georgia Assistant Attorney General Henry A. Hibbert are prosecuting the case.
For further information please contact the U.S. Attorney’s Public Affairs Office at USAGAN.Pressefirstname.lastname@example.org 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.