Tag Archives: New Century Adult Day Program Services LLC

Owner of Fake Michigan Psychotherapy Clinic Sentenced for Role in Medicare Fraud Scheme

Posted on by
The owner of two Flint, Mich., adult day care centers was sentenced today for his leadership role in a $3.2 million Medicare fraud scheme.
Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division, U.S. Attorney for the Eastern District of Michigan Barbara L. McQuade, Special Agent in Charge Paul M. Abbate of the FBI’s Detroit Field Office and Special Agent in Charge Lamont Pugh III of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) Chicago Regional Office made the announcement.
Glenn English, 53, was sentenced by United States District Judge Victoria A. Roberts in the Eastern District of Michigan to serve 96 months in prison.   In addition to his prison term, English was sentenced to serve three years of supervised release and was ordered to pay $988,529 in restitution.
On Oct. 18, 2013, English and co-defendant Richard Hogan were found guilty by a federal jury for their roles in organizing and directing a psychotherapy fraud scheme through New Century Adult Day Program Services LLC and New Century Adult Day Treatment Inc. (together, New Century).   English was convicted of one count of conspiracy to commit health care fraud and seven counts of health care fraud, and Hogan was convicted of one count of conspiracy to commit health care fraud.
E vidence presented at trial showed that from 2009 through 2012, New Century operated  as an adult day care center that billed Medicare for psychotherapy services.   English was New Century’s owner and chief executive officer.   New Century brought in mentally disabled residents of Flint-area adult foster care (AFC) homes, as well as people seeking narcotic drugs, and used their names to bill Medicare for psychotherapy that was not provided.   English and his co-conspirators lured drug seekers to New Century with the promise that they could see a doctor there who would prescribe to them the narcotics they wanted if they signed up for the psychotherapy program.   New Century used the signatures and Medicare information of these drug seekers and AFC residents to claim that it was providing them psychotherapy, when in fact it was not.
The evidence also showed that English directed New Century employees to fabricate patient records to give the false impression that psychotherapy was being provided.   English also instructed New Century clients to pre-sign sign-in sheets for months at a time for dates they were not there, and used these signatures to claim to Medicare that these clients had been provided services.
The evidence at trial showed that in little more than two years, New Century submitted approximately $3.28 million in claims to Medicare for psychotherapy that was not provided.   Medicare paid New Century $988,529 on these claims.
This case was investigated by the FBI and HHS-OIG and was brought as part of the Medicare Fraud Strike Force, under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Eastern District of Michigan.   This case was prosecuted by Trial Attorneys William G. Kanellis and Henry P. Van Dyck of the Fraud Section, with assistance from Assistant Chief Catherine K. Dick.
Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged more than 1,700 defendants who have collectively billed the Medicare program for more than $5.5 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.

 

Operators of Michigan Adult Day Care Centers Convicted in $3.2 Million Medicare Fraud Scheme

Posted on by
A federal jury in Detroit today convicted the owner and the program coordinator of two Flint, Mich., adult day care centers for their participation in a $3.2 million Medicare fraud scheme.

Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division; U.S. Attorney Barbara L. McQuade of the Eastern District of Michigan; Acting Special Agent in Charge John Robert Shoup of the FBI Detroit Field Office; and Special Agent in Charge Lamont Pugh III of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG), Office of Investigations Detroit Office made the announcement.

Glenn English, 53, was found guilty in U.S. District Court for the Eastern District of Michigan of one count of conspiracy to commit health care fraud and seven counts of health care fraud for directing a psychotherapy fraud scheme through New Century Adult Day Program Services LLC and New Century Adult Day Treatment Inc. (collectively known as New Century).

Richard Hogan, 67, an unlicensed social worker who worked as a program coordinator at New Century, was found guilty of one count of conspiracy to commit health care fraud.

The defendants were charged in a superseding indictment returned Dec. 11, 2012.  Another individual charged in the superseding indictment, Donald Berry, awaits trial at a later date.

According to evidence presented at trial, English owned and operated New Century as an adult day care center through which he billed Medicare for individual and group psychotherapy services.  As shown at trial, New Century brought in mentally disabled residents of Flint-area adult foster care homes (AFCs), as well as people seeking narcotic drugs, and used their names to bill Medicare for psychotherapy that was not provided.  The evidence showed that English and Hogan lured drug seekers to New Century with the promise that they could see a doctor there who would prescribe for them the narcotics they wanted if they signed up for the psychotherapy program.  New Century used the signatures and Medicare information of these AFC residents and drug seekers to claim that it was providing them psychotherapy, when in fact it was not.
The evidence also showed that English directed New Century employees to fabricate patient records to give the false impression that psychotherapy was being provided.  Social workers and untrained employees wrote fake progress notes for therapy sessions that never occurred.  Further, English and New Century employees directed New Century clients to pre-sign sign-in sheets for months at a time, and used these signatures to claim to Medicare they had provided services.  On multiple occasions, New Century billed Medicare as if its social workers had provided over 24 hours of care in a single day.

From March 2010 through April 2012, New Century billed approximately $3.2 million and received more than $988,000 from Medicare.

The health care fraud conspiracy count carries a maximum potential penalty of 10 years in prison; each count of health care fraud carries a maximum penalty of 10 years in prison.  Sentencing for both defendants is scheduled for Feb. 27, 2014.

The investigation was led by the FBI and HHS-OIG and was brought by the Medicare Fraud Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Eastern District of Michigan.

Since its inception in March 2007, the Medicare Fraud Strike Force, now operating in nine cities across the country, has charged more than 1,500 defendants who have collectively billed the Medicare program for more than $5 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.

Michigan Physician Pleads Guilty for Role in Medicare Fraud Scheme

Posted on by
A Detroit-area physician pleaded guilty today to making fraudulent referrals for home health care as part of a $1.6 million home health care fraud scheme, announced Acting Assistant Attorney General Mythili Raman of the Justice Department’s Criminal Division, U.S. Attorney for the Eastern District of Michigan Barbara L. McQuade, Special Agent in Charge Robert D. Foley III of the FBI’s Detroit Field Office and Special Agent in Charge Lamont Pugh III of the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG), Chicago Regional Office.

Dr. Sonjai Poonpanij, 82, of Rochester, Mich., pleaded guilty before Senior U.S. District Judge Arthur J. Tarnow in the Eastern District of Michigan to one count of conspiracy to commit health care fraud.

According to court documents, Dr. Poonpanij admitted that beginning in approximately July 2010, he conspired with others to commit health care fraud by referring Medicare beneficiaries for home health care that was not medically necessary and causing false and fraudulent claims to be submitted to Medicare.

Dr. Poonpanij admitted that he saw patients at a psychotherapy center in Flint, Mich., known as New Century Adult Day Program Services LLC, and referred Medicare beneficiaries at New Century to home health care companies – including a home health care company known as Angle’s Touch Home Health Care LLC – even though he knew that those beneficiaries did not qualify for home health care.  According to court documents, Dr. Poonpanij wrote prescriptions for narcotics requested by the beneficiaries in exchange for their enrollment with Angle’s Touch for home health care that they did not need or receive.  In addition to referring patients that he saw at New Century, Dr. Poonpanij also referred beneficiaries whom he had never seen or treated to Angle’s Touch and other home health agencies.  Dr. Poonpanij signed plans of care for these beneficiaries that were used to bill Medicare for services that were either never actually performed or were not performed in the beneficiaries’ homes as required.

Court documents allege that between September 2008 and September 2012, Dr. Poonpanij caused Angle’s Touch and two other home health agencies to submit claims to Medicare for services that were not medically necessary and/or not provided, which caused Medicare to pay these companies approximately $1,318,954.

At sentencing, scheduled for Aug. 14, 2013, Dr. Poonpanij faces a maximum penalty of 10 years in prison and a $250,000 fine.

This case is being prosecuted by Trial Attorney Niall M. O’Donnell of the Criminal Division’s Fraud Section.  It was 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 Eastern District of Michigan.

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.