Dallas County Woman Admits Defrauding Medicaid
DALLAS—Brenda Ward, 47, of Cedar Hill, Texas, appeared in federal court this morning before U.S. District Judge Sidney A. Fitzwater and pleaded guilty to one count of health care fraud, announced John Parker, U.S. Attorney for the Northern District of Texas.
Ward, who remains on bond, faces a maximum statutory penalty of 10 years in federal prison and a $250,000 fine. Sentencing is set for November 6, 2015, before Judge Fitzwater.
According to documents filed in the case, Ward, who was President and CEO of H.E.L.P.-Ing. Communities, Inc. (HCI), obtained a Medicaid group number for HCI and used that number, together with individual Medicaid provider numbers of licensed counselors and Medicaid recipient information, to submit fraudulent claims to Medicaid.
Ward, who is neither a psychotherapist nor a mental health provider, submitted claims for individual, family, and group psychotherapy sessions that were not performed. As part of her fraud scheme, Ward used the Medicaid provider numbers of four licensed counselors, without their knowledge and consent, to submit claims under the HCI group number for services that they did not perform. Ward also used the Medicaid provider information of a fifth licensed counselor who worked for her to submit claims for psychotherapy services that both predated and postdated the counselor’s actual employment with her, as well as claims for services that the counselor did not provide during the counselor’s employment. Ward used the identification of more than 290 Medicaid recipients, most of whom were minor children, in her scheme.
Ward admits that from January 1, 2009, through February 9, 2015, she personally submitted fraudulent claims to Medicaid and to Medicaid Managed Care Organizations, through HCI, totaling approximately $1,639,923.00; Ward was paid approximately $887,809.64 for these claims.
The FBI, the U.S. Department of Health and Human Services—Office of Inspector General and the Texas Attorney General’s Medicaid Fraud Control Unit investigated. Assistant U.S. Attorney Douglas Brasher is prosecuting.