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Jan. 10, 2011

OWNER OF BEHAVIORAL COUNSELING COMPANY SENTENCED TO PRISON FOR HEALTH CARE FRAUD SCHEME

Court orders defendant to pay almost $1 million in restitution

(HOUSTON) – Edward Birts, 51, the owner/operator of Courage to Change, a Houston behavioral counseling company has been sentenced to more than five years in federal prison without parole and ordered to pay $968,583 in restitution to Medicare and Medicaid for defrauding the health care programs, United States Attorney José Angel Moreno announced today.

United States District Court Vanessa Gilmore handed down a sentence of 65 months incarceration to be followed by a three year term of supervised release at a hearing held this morning. Twenty-four months of the 65 constitute the mandatory sentence  for an aggravated identity theft conviction which must be served consecutive to the sentences imposed for the health care fraud convictions. Birts was convicted of conspiracy to commit healthcare fraud, health care fraud, and aggravated identity theft. Restitution in the amount of $968,583.58 has also been ordered. Birts pleaded guilty in June 2010.   

As the owner and operator of Courage to Change, Birts represented himself as a doctor in psychology (PhD), when in fact he had  purchased a doctoral degree online and then awarded himself several bogus professional certifications in counseling. Birts unlawfully acquired from co-conspirators known and unknown by the grand jury Medicaid beneficiaries’ information, including names, addresses, and Medicaid numbers, which he used to file false claims. Then, through his counseling business, Birts routinely billed Medicaid for group therapy sessions and psychiatric counseling that were not provided to the beneficiaries.  

Despite the fact that Birts was not legally licensed, or even professionally qualified as a psychiatrist, psychologist, or a counsel, Birts regularly billed Medicaid and Medicare for psychiatric counseling services provided by himself. Birts also routinely billed Medicaid and Medicare for psychiatric counseling services provided by “Dr. R.B.” on behalf of Courage to Change, Inc., when in fact, “Dr. R.B.” did not provide the services, nor was he employed nor contracted by Courage to Change, Inc. to do so.

Through January 2003 through September 2006, Birts billed Medicaid and Medicare for claims totaling approximately $ 1,282,466.87 and received payments for those claims totaling approximately $ 968,583.58. 

Birts, who has been in custody since his arrest March 2010 arrest, will remain in custody to serve his sentence.

This case was the result of the investigative efforts of the United States Department of Health and Human Services - Office of the Inspector General, and the Texas Attorney General’s Medicaid Fraud Unit in Houston. Special Assistant United States Attorney Justo A. Mendez prosecuted the case.

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