Connecticut Office Manager Pleads Guilty to Health Care Fraud Charges for Billing for Psychotherapy Services Using Social Worker's Provider Number Who Did Not Provide Services

Mental health audits and prosecutions are on the rise in “behavioral health” which includes a wide variety of health care providers who provide care on an outpatient basis. These providers include psychiatrists, psychologists, licensed clinical social workers, licensed marriage and family therapists, licensed professional counselors, and licensed alcohol and drug counselors.  

Managers are often charged in health care fraud cases and a recent case relates to a manager's alleged participation in fraud and abuse in outpatient behavioral health. On December 14, 2016, office manager Maurice Sharpe of Connecticut waived his right to indictment and pleaded guilty before U.S. District Judge Bolden to one count of health care fraud. The facts relate to billing for psychotherapy services provided by unlicensed individuals, using another provider's Medicaid number or billing for services not provided.