Ronan Counselor Pleads Guilty to Fraudulently Submitting Federal Claims
MISSOULA—A Ronan counselor who defrauded Medicaid of over $40,000 has pleaded guilty to federal charges alleging that he submitted fraudulent claims for counseling public school children whom he had never met. Stanley Fleming, a 56-year-old Licensed Clinical Profession Counselor, pleaded guilty to health care fraud. He will be sentenced on February 12, 2015 and faces 10 years’ imprisonment, $250,000 in fines and three years’ supervised release.
Assistant U.S. Attorney Chad Spraker told the court that for the past 19 years, Fleming has provided services for the Ronan school district, including determining whether children are eligible for an Individual Education Program under the Individuals with Disabilities Education Act. In July 2009, authorities received a complaint that Fleming had billed for services provided to a child who had never seen Fleming. Medicaid investigators conducted a review of Fleming’s billings activities. Fleming told investigators that his computer hard drive and personal digital assistant were compromised by a computer virus in March 2008 which, according to Fleming, caused him to lose all records documenting the services he had rendered before that date. Fleming later produced records for some of the claims, consisting of hand-written notes written on index-card-size sheets of paper. Some of the records lacked a patient name and a date of service. Investigators were able to contact and interview 35 patients, 20 of whom denied receiving any services from Fleming.
Besides billing for non-existent sessions, investigators also determined that Fleming had defrauded the program in other ways.
Billing Medicaid for counselling services where program guidelines did not recommend counseling. In many of these cases, the student or his or her guardian also denied the counseling session took place.
Federal claims were also submitted for counselling services during months when school was not in session and no contact would have been made.
Fleming also billed Medicaid for counseling services on the same day and for the same student that the Ronan school district had billed Medicaid thereby double-billing for the same service rendered.
The case was investigated by the Health Care Fraud Investigator for the U.S. Attorney’s Office, the Federal Bureau of Investigation and the Montana Department of Health and Human Services, Surveillance and Utilization Review Unit.