Mar. 3, 2010
HOUSTON AREA BEHAVIORAL COUNSELING BUSINESS OWNER CHARGED WITH DEFRAUDING MEDICAID
(HOUSTON) – A 17-count indictment charging the owner of a Houston area behavioral counseling business arising from a scheme to defraud Medicaid of more than one million dollars and aggravated identity theft has been unsealed, United States Attorney José Angel Moreno and Texas Attorney General Greg Abbott announced today.
The indictment, returned under seal on Feb. 24, 2010, was unsealed today following the arrest of Edward Birts, 51, the owner of Courage to Change - a Houston area behavioral counseling business. Birts is expected to make his initial appearance in federal court today.
Birts is accused of aggravated identity theft for allegedly unlawfully acquiring Medicaid beneficiaries’ information, including names, addresses and Medicaid numbers, then using the information to file false claims through his counseling business. Birts allegedly routinely billed Medicaid for group therapy sessions and psychiatric counseling that were not provided to the beneficiaries.
The conspiracy to commit health care fraud and health care fraud counts arise from allegations that Birts, who has reportedly represented himself as a doctor in psychology (PhD), regularly billed Medicaid and Medicare for psychiatric counseling services he provided. However, the indictment alleges Birts purchased a doctoral degree online and then awarded himself several bogus professional certifications in counseling, thus is not legally licensed or professionally qualified as a psychiatrist, psychologist or a counselor. Other health care fraud counts arise from accusations that Birts routinely billed Medicaid and Medicare for psychiatric counseling services provided by “Dr. R. B.” on behalf of Courage to Change Inc. when “Dr. R.B.” did not provide the services and was neither employed nor contracted by Courage to Change Inc.
The indictment alleges the scheme to defraud the federal medical benefits program began in January 2003 and continued through September 2006. During that time period, Birts allegedly billed Medicaid and Medicare for claims totaling approximately $ 1,282,466.87 and received payments for those claims totaling approximately $968,583.58.
The conspiracy and each of the 12 health care fraud counts carry a maximum sentence of 10 years imprisonment and a $250,000 fine upon conviction. A conviction for aggravated identity carries a mandatory two-year-term of imprisonment for each of the four counts of aggravated identity theft.
This case was the result of the investigative efforts of the Department of Health and Human Services-Office of Inspector General and the Texas Attorney General’s Medicaid Fraud Unit in Houston. Special Assistant United States Attorney Justo A. Mendez is prosecuting the case.
An indictment is a formal accusation of criminal conduct, not evidence.
A defendant is presumed innocent unless and until convicted through due process of law.
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