Therapist’s ex-wife uses his provider number to submit $617,983 in fake claims, feds say

·2 min read
Getty Images/iStockphoto

After separating from her husband who worked as a therapist, a Texas woman began defrauding Medicaid using his provider number, authorities said.

Now the 47-year-old woman has pleaded guilty to health care fraud, according to a March 22 news release from the U.S. Attorney’s Office for the Southern District of Texas.

Authorities said the woman, who lived in Katy, worked for her spouse’s business as an office manager from about 2009 until 2013, the same year they separated. The couple divorced in 2014.

While working as an office manager, she was tasked with scheduling patient visits, billing insurance companies and maintaining enrollment in Medicaid and Amerigroup, according to her plea agreement. She had access to patient information, billing information and her husband’s credentials.

Her husband stopped offering psychotherapy services in 2013, officials said, and the woman was no longer employed as an office manager.

But after this, the woman began submitting fraudulent claims to Medicaid without her ex-husband’s knowledge, according to court records. She claimed her ex had provided psychotherapy services to patients.

The woman’s defense attorney did not immediately respond to a request for comment from McClatchy News on March 23.

She submitted 434 fake claims to Amerigroup between January 2013 and September 2017, prosecutors said.

Then in September 2017, the woman got a job as an office manager for a pediatrician, according to the plea agreement. From November 2017 to March 2018, authorities said she submitted bogus Medicaid claims for 25 patients associated with the pediatrician.

In those claims, she said the patients received psychotherapy services from her ex, authorities said.

In total, authorities said she submitted about $617,983 worth of fake claims. She received about $432,924 from those Medicaid claims.

The woman faces up to 10 years in prison and a $250,000 fine, officials said. She’s scheduled to be sentenced on June 20.

Katy is about 30 miles west of Houston.

Doctor removed thin layer of tissue lining patients’ uteruses when unnecessary, feds say

Health aide billed 3,400 hours of work while he traveled abroad instead, feds say

Bogus company stole $2.5 million from Medicaid and left town, Missouri prosecutors say