Licensed Clinical Social Worker Sentenced to Prison for Health Care Fraud
BATON ROUGE, LA—United States Attorney Walt Green announced that CARLA CLARK, age 50, of Pineville, Louisiana, was sentenced yesterday by Chief U.S. District Judge Brian A. Jackson to 21 months’ imprisonment, two years of supervised release following imprisonment, and ordered to pay $413,109 in restitution for her role in a health care fraud scheme involving two Louisiana companies.
The sentencing stems from a health care fraud scheme involving two companies known as Fusion Services, L.L.C. (“Fusion”), and Grace Social Services, L.L.C. (“Grace”), which operated in Alexandria, Louisiana and the surrounding areas. CLARK was a Licensed Clinical Social Worker who worked with Sonya Williams, the owner of Fusion and Grace. CLARK participated in creating false and misleading medical records for Fusion indicating that Medicare beneficiaries had received individual, face-to-face psychotherapy when, in fact, no such services had been provided. Williams then prepared false claims for the purported psychotherapy services to elderly patients and submitted them to Medicare for reimbursement. Medicare paid Fusion and Grace approximately $349,715 as a result of the billings, much of the profits were deposited into Williams’ personal accounts.
In addition to the term of imprisonment, Judge Jackson ordered CLARK to pay restitution in the amount of $413,109 to the Department of Health and Human Services/Centers for Medicare and Medicaid Services for her role in the fraudulent conduct involving Fusion and Grace, as well as other health care entities.
U.S. Attorney Green stated, “This sentencing is part of the continuing effort by my office and our federal, state, and local partners to combat the scourge of health care fraud. Corrupt medical professionals, like the defendant in this case, do an incredible disservice to the vast majority of medical professionals who are honest and committed to quality patient care. Together with the help and cooperation of those honest professionals, we will continue our pursuit of fraudsters in the medical community.”
“Any time false claims are submitted for payment, the nation’s health insurance programs suffer,” said Special Agent-in-Charge Mike Fields of the HHS Office of the Inspector General’s (OIG) Dallas Regional Office. “Our HHS OIG investigators will continue to work closely with our law enforcement partners to identify providers who deliberately manipulate the system to obtain crucial Medicare or Medicaid dollars.”
The investigation was conducted by the U.S. Department of Health and Human Services’ Office of Inspector General (HHS-OIG) and the Federal Bureau of Investigation (FBI), with the assistance of AdvanceMed, the Medicare Program Safeguard Contractor which assists with health care fraud investigations. The case was prosecuted by Assistant United States Attorney Catherine M. Maraist.