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Autistic care providers accused of health care fraud

Government officials recently charged two women with health care fraud. The case is unique as the charges are the result of allegations connected to the women’s practice providing care for autistic children.

Prosecution states autistic services a front for fraudulent charges

The alleged scheme ran from 2009 to 2016. During this time, the prosecution states the women charged Medicaid for services the autistic children never received. The government gathered evidence primarily through testimony of former employees. These whistleblowers stated the “culture and climate” of the facility was one that encouraged fraudulent billing practices.

Parents of patients spoke out in support of the women. They state the women provided their children with quality care. However, the government stated the women charged Medicaid for care the children never received.

Government offers opportunity to accept misdemeanor instead of felony charges

The women chose to accept a plea deal. As part of the deal, the government would agree to pursue misdemeanor charges. If they had not accepted the deal, they faced felony charges. The felony charges, if convicted, would have come with a minimum 4-year prison sentence. With the misdemeanor charges, the women will instead face a six-month prison sentence and the ability to potentially get their health care licenses back in the future.

As part of the plea deal, the women agreed to provide evidence against the founder of the facility. The prosecution has stated it will seek $9 million in restitution from the founder.

Weigh all options before choosing to deal with government

The case provides an example of the types of options the government will present those accused of health care fraud crimes. It is important for those who are accused of similar crimes to consider all options, including building a defense to maintain innocence.