Nine Individuals – Employees and Owner of Eyes For Change Youth & Family Services – Indicted for Deceitful Medicaid Charging practices.
On 12th November 2020, Bridget Brennan, First Assistant United States Attorney, announced that a Grand Jury Sitting in Cleveland had submitted 28-count charges charging nine persons for their role and participation in a conspiracy to defraud the Medicaid program. These nine persons either operated, owned, or worked for Eyes For Change Youth & Family Services, Inc., a non-profit corporation in Cleveland.
Bridget Brennan, First Assistant United States Attorney; Special Agent Eric B. Smith in Charge of the FBI; Special Agent in Charge Lamont Pugh III of the U.S. Department of Health and Human Services – Office of the Inspector General; and Attorney General Dave Yost for Ohio announced the grand jury’s submission.
Bridget Brennan, First Assistant United States Attorney, stated that the accused persons are indicted with defrauding a federally-funded health care program that was established to help some of the most vulnerable people within their community. First Assistant United States Attorney Brennan further added that the defendants’ purported behavior, such as reimbursement of kickbacks, was plotted to line their pockets and satisfy their gluttony. Brennan concluded by acknowledging and applauding their hard work and relentless collaboration and commitment from their law enforcement agencies towards bringing accusations of fraud and illicit kickbacks before the court.
Special Agent Eric B. Smith in Charge of the FBI stated that these persons participated in a conspiracy to swindle taxpayers by submitting fraudulent and false billings to a federally-funded health care program, which is funded by hardworking citizens. Smith further added that the FBI would continue to collaborate with their law enforcement partners to root out such fraud schemes and hold accountable individuals who participate in unlawful financial dealings.
Special Agent in Charge Lamont Pugh III of the U.S. Department of Health and Human Services – Office of the Inspector General stated that the charging of medical services that are not provided, the reimbursement of kickbacks, and the fabrication and forging of documents with respect to medical records are unlawful acts commonly used by individuals who commit health care fraud. Lamont Pugh III further added that the OIG routinely carries out data analysis in an effort to divergent and potentially fraudulent and deceitful billing trends and will take actions to hold accountable individuals who seek to swindle government-funded health care programs.
Attorney General Dave Yost for Ohio stated that there are actually real individuals out there who are suffering and require assistance. Yost further added that there is no need to create imaginary patients, and a jury of their peers will indisputably know some of them. Yost concluded by acknowledging their partnership with the state and federal law enforcement agencies to bring these corrupt people to justice.
Named in the Charge are;
- Alfonzo D. Bailey, from Cleveland, Ohio, age 38. Alfonzo Bailey was the incorporator and full owner of Eye For Change Youth & Family Services, Inc.
- David Brown, from Maple Heights, Ohio, age 39. David Brown was a Clients Rights Officer and marketer at Eye For Change & Family Services, Inc.
- Valerie White, from Columbus, Ohio, age 51. Valerie White worked as a QMHS (Qualified Mental Health Specialist) and a therapist or counselor who gave counseling services to Eye For Change & Family Services, Inc. Medicaid beneficiary clients.
- Sandra Wilson, from Cleveland, Ohio age 52. Sandra Wilson worked as an assessor and staffed the emergency hotline at Eye For Change & Family Services, Inc. and offered counseling services to Medicaid beneficiary clients.
- Cheria Oliver, from Canal Winchester, Ohio, age 31. Cheria Oliver worked as a QMHS (Qualified Mental Health Specialist) at Eye For Change & Family Services, Inc. and gave counseling services to Medicaid beneficiary clients.
- Charchee Tucker, from Warrensville Heights, Ohio, age 43. Charchee Tucker worked as QMHS, Lead Case Manager, QMHS Supervisor, and Director of Marketing and Compliance. Charchee Tucker offered counseling services to Eye for Change & Family Services, Inc., Medicaid beneficiary clients.
- Allen Steele, from Parma, Ohio, age 38. Allen Steele worked as a QMHS at Eye For Change & Family Services, Inc. and was able to give counseling services to Medicaid beneficiary clients.
- Kamelah Ganaway, from Macedonia, Ohio, age 43. Kamelah Ganaway worked as a QMHS at Eye For Change & Family Services, Inc. and was to offer counseling services to Medicaid beneficiary clients.
- Tremayne Kellom, from Cleveland, Ohio, age 41.
As per the indictment, from February 2017 to September 2020, the accused persons are accused of submitting, or permitting to be submitted, billings of fraudulent and falsified records to the Medicaid program for services that were never performed.
The accusation states that Alfonzo Bailey would reimburse Wilson and White, a LISW (Licensed Independent Social Worker), in order to use Wilson’s LISW provider credentials and number to submit billings and records regarding mental health tests that were never performed.
Brown, Bailey, Wilson, and White would further submit billings to the Medicaid program for counseling services without a proper treatment plan in place for clients, as demanded by law.
Additionally, Brown, Bailey, Wilson, and White are indicted for purportedly reimbursing kickbacks in the form of gift cards, cash, and bill/rent reimbursements to Medicaid beneficiaries in order to have these beneficiaries as clients and to bill the Medicaid program for unprovided services.
The charge further states that Brown, Bailey, Wilson, and White would instruct workers to misdiagnose their Medicaid beneficiaries in order to obtain authorization from the Ohio Medicaid Department to offer services and charge at higher rates.
Brown, Bailey, Tucker, Ganaway, Steele, Kellom, and Oliver are further accused of purportedly instructing and permitting workers to insert falsified progress notes into Medicaid beneficiary electronic records in order to produce fictitious records required to submit their claims.
Due to these crimes, the accused individuals shall forfeit nearly 2.3 million U.S. dollars confiscated during the execution of a federal seizure warrant and entire properties linked with Eye For Change & Family Services, Inc. in Cleveland, Cleveland Heights, and Columbus.
A charge is merely an accusation and is not guilty proof. The accused individuals have a right to fair trial and prosecution, where it will be the government’s task to prove the accused guilty of the charges beyond a reasonable doubt.
If sentenced, the accused individuals’ conviction sentence will be imposed by the Court after reviewing factors unique to this matter, like the accused individuals’ past criminal record, if any, the characteristics of the breach, and the accused persons’ role in the crime.
In every case, the conviction will not exceed the mandatory maximum sentence, and in many cases, it will be less than the maximum.
The FBI – Cleveland Division, the Ohio Attorney General’s Health Care Fraud Unit, and the United States Department of Health and Human Services – Office of the Inspector General conducted the investigations leading to these indictments. United States Assistant Attorney Michael L. Collyer and Special U.S. Assistant Attorney Jonathan L. Metzler are prosecuting the case.
Committing Health Fraud by defrauding the Medicaid program, breaking the False Claims Act, or breaching the controlled Substance Statute is a serious crime. Individuals who commit these crimes violate the law and are severely penalized if found guilty of the charges. Once charged for these offenses, you must look for the best legal representation or help to protect and pursue your rights. Hire our highly proficient team of defense and criminal lawyers if you require the best legal representation, help, and advice, which will lead to attaining positive results for your matter. At Health Care Fraud Group, we consist of a highly experienced team of attorneys with numerous years of experience in handling Health Care Fraud related issues associated with the Federal Health Care Program; they are very knowledgeable about civil and federal cases. The defense lawyers are well recognized across the United States due to their excellent work and professionalism when dealing with health care fraud cases and inquiries. They are well furnished with previous knowledge of every aspect of Health Care fraud defense, medical, and legal issues.
Our offices are always open, and we are well prepared and ready to commence your defense immediately. We are the most popular law firm because we are continually updating our practices and knowledge in order to act swiftly on your issue without the need for persistent legal consultations. We offer a safe and quick evaluation of your issue and act quickly to collect, acquire, and assemble the needed and key particulars about your matter in the government’s investigations. When hired, we will help you and your team come up with the right and best decision. Our highly proficient team of lawyers will assist and guide throughout your case; you should evade facing a health care fraud investigation since there are many key mistakes. Also, we will offer you and your team with detailed legal assistance and defense in issues and investigations that are in charge and even those in other institutions or firms that cover the IRS and the FBI, and investigations and matters that are under the jurisdiction of the CMS, OIG, DHHS, DOJ, and DEA. We will further investigate potential health care fraud and assist keep both you and your career safe. Our qualified attorneys at the Health Care Fraud Group are conversant and clearly understand the need to prove innocence after accusation of any crime. For any legal representation, advice, or help you may need, contact us at 888-402-4054.
