Health Care Clinic Director Pleads Guilty in Miami for Role in $63 Million Fraud Scheme

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Department of Justice
Office of Public Affairs
FOR IMMEDIATE RELEASETuesday, May 7, 2013
Health Care Clinic Director Pleads Guilty in Miami for Role in $63
Million Fraud Scheme
A former health care clinic director and licensed clinical
psychologist pleaded guilty today in connection with a health care
fraud scheme involving defunct health provider Health Care Solutions
Network Inc. (HCSN), announced Acting Assistant Attorney General
Mythili Raman of the Justice Department's Criminal Division; U.S.
Attorney Wifredo A. Ferrer of the Southern District of Florida;
Michael B. Steinbach, Special Agent in Charge of the FBI's Miami Field
Office; and Special Agent in Charge Christopher B. Dennis of the U.S.
Department of Health and Human Services Office of Inspector General
(HHS-OIG), Office of Investigations Miami office.

Alina Feas, 53, of Miami, pleaded guilty before U.S. District Judge
Cecilia M. Altonaga in the Southern District of Florida to one count
of conspiracy to commit health care fraud and one substantive count of
health care fraud.

During the course of the conspiracy, Feas was employed as a therapist
and clinical director of HCSN’s Partial Hospitalization Program
(PHP). A PHP is a form of intensive treatment for severe mental
illness. HCSN operated two community mental health centers in Florida
and one community mental health center in North Carolina.

In her capacity as clinical director, Feas oversaw the entire clinical
program and supervised therapists and other personnel at HCSN in
Florida (HCSN-FL). Feas also conducted group therapy sessions when
therapists were absent.

According to court documents, Feas was aware that HCSN-FL paid illegal
kickbacks to owners and operators of assisted living facilities (ALF)
in Miami-Dade County in exchange for patient referral information to
be used to submit false and fraudulent claims to Medicare and
Medicaid. Feas knew that many of the ALF referral patients were
ineligible for PHP services because they suffered from either mental
retardation, dementia or Alzheimer's disease, which are not
effectively treated by PHP services.

Court documents reveal that Feas submitted claims to Medicare for
individual therapy she purportedly provided to HCSN-FL patients using
her personal Medicare provider number, knowing that HCSN-FL was
simultaneously billing the same patients for PHP services. Feas
continued to bill Medicare under her personal provider number while
HCSN in North Carolina (HCSN-NC) simultaneously submitted false and
fraudulent PHP claims.

Feas was aware that HCSN-FL personnel were fabricating patient medical
records, according to court documents. Many of these medical records
were created weeks or months after the patients were admitted to HCSN-
FL for purported PHP treatment and were utilized to support false and
fraudulent billing to government sponsored health care benefit
programs, including Medicare and Florida Medicaid. During her
employment at HCSN-FL, Feas signed fabricated PHP therapy notes and
other medical records used to support false claims to government
sponsored health care programs.

At HCSN-NC, Feas was aware that her co-conspirators were fabricating
medical records to support the fraudulent claims she was causing to be
submitted to Medicare. Feas was aware that a majority of the
fabricated notes were created at the HCSN-FL facility for patients
admitted to HCSN-NC. In some instances, Feas signed therapy notes and
other medical records even though she never provided services at HCSN-
NC.

According to court documents, from 2004 through 2011, HCSN billed
Medicare and the Florida Medicaid program approximately $63 million
for purported mental health services.

Fifteen defendants have been charged for their alleged roles in the
HCSN health care fraud scheme, and 13 defendants have pleaded guilty.
On April 25, 2013, Wondera Eason was convicted, following a five-day
jury trial, on one count of conspiracy to commit health care fraud for
her role in the scheme at HCSN. Alleged co-conspirator Lisset Palmero
is scheduled for trial on June 3, 2013. Defendants are presumed
innocent until proven guilty at trial.

This case was prosecuted by Trial Attorney Allan J. Medina and former
Special Trial Attorney William J. Parente. This case is being
investigated by the FBI and HHS-OIG and was brought as part of the
Medicare Fraud Strike Force, supervised by the Criminal Division's
Fraud Section and the U.S. Attorney's Office for the Southern District
of Florida.

Since its inception in March 2007, the Medicare Fraud Strike Force,
now operating in nine cities across the country, has charged more than
1,480 defendants who have collectively billed the Medicare program for
more than $4.8 billion. In addition, HHS’s Centers for Medicare and
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
Action Team (HEAT), go to: www.stopmedicarefraud.gov.




http://www.justice.gov/opa/pr/2013/May/13-crm-513.html