Michigan Psychotherapy Clinic Owner Sentenced to 87 Months in Prison for His Role in $3.3 Million Medicare Fraud Scheme
WASHINGTON—A former Michigan resident who directed a $3.3 million psychotherapy fraud scheme was sentenced today to 87 months in prison, announced Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division, U.S. Attorney Barbara L. McQuade of the Eastern District of Michigan, Special Agent in Charge Paul Abbate of the FBI Detroit Field Office and Special Agent in Charge Lamont Pugh III of the Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Detroit Office.
Gerald R. Funderburg Jr., 35, of Syracuse, New York, was sentenced by U.S. District Judge Stephen J. Murphy III in the Eastern District of Michigan. In addition to his prison term, Funderburg was ordered to pay $1,453,064.59 in restitution.
According to admissions made in connection with his guilty plea, from November 2006 through April 2011, Funderburg owned and controlled Funderburg Clinical & Community Services (FCCS), which he used to submit false claims to Medicare for purported psychotherapy services.
Funderburg admitted that he used the Medicare information and identities of hundreds of Medicare beneficiaries without their consent to submit claims for psychotherapy services that were not actually provided. Funderburg also admitted that he used personal information of licensed social workers without their consent to obtain Medicare provider numbers in their names, which he then used to submit false claims to Medicare for services purportedly provided by the same social workers. The social workers, however, did not provide the care for which Funderburg billed Medicare.
Over the course of the scheme, Funderburg admitted that he caused FCCS to submit over $3.3 million in fraudulent claims, and Medicare paid $1,453,064 for those claims.
This case was investigated by the FBI and HHS-OIG, and was brought by the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and U.S. Attorney’s Office for the Eastern District of Michigan. The case was prosecuted by Deputy Chief Gejaa T. Gobena, Assistant Chief Catherine K. Dick and Trial Attorneys Matthew C. Thuesen, Dustin M. Davis and William G. Kanellis of the Criminal Division’s Fraud Section.
Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged nearly 2,100 defendants who have collectively billed the Medicare program for more than $6.5 billion. In addition, HHS’s Centers for Medicare & Medicaid Services, working in conjunction with HHS-OIG, is taking steps to increase accountability and decrease the presence of fraudulent providers.
To learn more about the Health Care Fraud Prevention and Enforcement Team (HEAT), go to: www.stopmedicarefraud.gov.