Intensive In-Home Therapy Provider Sentenced to 24 Months for Health Care Fraud
RICHMOND, Va. – Michael Griffin, 37, of Richmond, Va., was sentenced today to 24 months in prison, followed by three years of supervised release, for Health Care Fraud, in violation of Title 18, United States Code, Section 1347. In addition, Griffin was ordered to pay $325,980.00 in restitution to the Department of Medical Assistance Services.
Neil H. MacBride, United States Attorney for the Eastern District of Virginia; and Kenneth T. Cuccinelli, Attorney General of Virginia, made the announcement after sentencing by United States District Judge Henry E. Hudson. Griffin waived indictment and plead guilty on February 27, 2012 to a one-count information alleging Health Care Fraud.
According to court documents, from on or about March 15, 2010, through on or about December 14, 2011, First Class Living Center, LLC (“First Class”), was an Intensive In-Home Therapy (IIH) provider located in the Eastern District of Virginia. IIH providers assist those youth and adolescents who are at risk of being removed from their homes, or are being returned to their homes after removal, because of a significant mental health, behavioral, or emotional issue. First Class was licensed through the Commonwealth of Virginia and under contract with Medicaid to provide IIH therapy. Griffin was the “Intensive In-Home Program Director” for First Class and submitted prior authorization documentation to initiate IIH services for Medicaid recipients. Medicaid relied on the prior-authorization paperwork Griffin prepared and submitted that requested approval to bill for IIH services. Griffin made false statements on prior-authorization forms and, as a result, First Class billed Medicaid at least $325,980.00 for medically unnecessary IIH services.
This case was investigated by the Office of the Attorney General Medicaid Fraud Control Unit with assistance from the Office of Inspector General, U.S. Department of Health & Human Services. Special Assistant United States Attorney Joseph E.H. Atkinson and Assistant United States Attorney Jessica Aber Brumberg prosecuted the case on behalf of the United States.A copy of this press release may be found on the website of the United States Attorney's Office for the Eastern District of Virginia at http://www.justice.gov/usao/vae. Related court documents and information may be found on the website of the District Court for the Eastern District of Virginia at http://www.vaed.uscourts.gov or on https://pcl.uscourts.gov.