Bristol Woman, 2 Others Charged with Health Care Fraud

Deirdre M. Daly, United States Attorney for the District of Connecticut, Phillip Coyne, Special Agent in Charge for the U.S. Department of Health and Human Services, Office of Inspector General, and Chief State’s Attorney Kevin T. Kane today announced that a federal grand jury in New Haven has returned an indictment charging RONNETTE BROWN, 43, of Bristol, with 23 counts of health care fraud and one count of conspiracy to commit health care fraud.

Brown was arrested yesterday.  She appeared before U.S. Magistrate Judge Donna F. Martinez in Hartford, entered a plea of not guilty to the charges in the indictment, and was released on a $100,000 bond.

This matter stems from an ongoing health care fraud investigation being conducted by the Office of the Inspector General of the U.S. Department of Health and Human Services, the Medicaid Fraud Control Unit of the Chief State’s Attorney’s Office, and the Connecticut Office of the Attorney General.  The investigation identified fraudulent activity in the area of behavioral health services.  Through the Medicaid program, the State of Connecticut provides coverage for mental health and counseling services to citizens who cannot otherwise afford health insurance.  “Behavioral health” includes a wide variety of health care providers who provide care on an outpatient basis, including psychiatrists, psychologists, licensed clinical social workers, licensed marriage and family therapists, licensed professional counselors, and licensed alcohol and drug counselors.

The indictment alleges that Brown owned and operated WeMPACT, LLC, a social services business with offices in Bristol and Torrington.  Between August 2010 and April 2014, Brown billed Medicaid for psychotherapy services that were not performed.  The indictment separately alleges that Brown conspired with Beverly Coker and another unnamed individual to bill Medicaid for psychotherapy services that represented Coker had performed the services, when in fact the services were provided by unlicensed individuals, or were not provided at all.

Each of the 24 counts in the indictment carries a maximum term of imprisonment of 10 years.

According to court documents and statements made in earlier court proceedings, Coker, a licensed clinical social worker, owned and operated New Beginnings Family Center, LLC, in Hartford.  On April 8, 2016, Coker, 68, of Windsor, waived her right to indictment and pleaded guilty to one count of health care fraud, admitting that between October 2010 and November 2011, she engaged in a scheme to defraud Medicaid by permitting two individuals to bill Medicaid for psychotherapy services using Coker’s Medicaid provider number.   The services were either performed by unlicensed individuals or not performed at all.  Under the scheme, Coker kept 30 percent of the proceeds, and paid the remaining 70 percent to the other two individuals.  As part of her plea, Coker admitted to defrauding Medicaid of approximately $214,555 through the scheme.

In addition, on May 2, 2016, Anne Charlotte Silver, 62, of Morris, pleaded guilty to one count of health care fraud.  Silver, a licensed clinical social worker, owned and operated Silver Counseling Services, LLC, in Canton and Bantam.  As part of her guilty plea, Silver admitted that between June 2011 and July 2015, she engaged in a scheme to defraud Medicaid by permitting an unnamed individual to bill Medicaid for psychotherapy services using Silver’s Medicaid provider number.   The services were either performed by unlicensed individuals or not performed at all.  Under the scheme, Silver kept 25 percent of the proceeds, and paid the remaining 75 percent to the other two individuals.  Silver admitted to defrauding Medicaid of approximately $1.6 million through the scheme.

Coker and Silver await sentencing.

“Behavior health specialists provide individuals of all ages the critical counseling needed to address serious mental health conditions,” said U.S. Attorney Daly.  “It is imperative that providers both deliver needed care to their patients, and bill Medicaid and other insurance programs honestly and accurately.  This ongoing investigation into the activities of a handful of unscrupulous providers is the result of coordination and joint investigation by HHS-OIG, the Medicaid Fraud Control Unit, the Attorney General’s Office, and our Office.  We also appreciate the invaluable work of the Connecticut Department of Social Services in identifying Medicaid fraud and promptly referring matters to law enforcement.  Through this partnership, we will continue to work to identify Medicaid fraud and bring civil and criminal prosecutions wherever warranted. ”

“Working with our federal and state partners, we will continue to protect the integrity of Medicare and Medicaid, which are designed to ensure the most vulnerable members of society receive the healthcare services they need,” said Special Agent in Charge Coyne.

“This is yet another example of how much we can achieve when agencies at all levels of government work together in collaboration,” said Chief State’s Attorney Kane.  “The charges announced today also will hopefully put all health care providers on notice that we are committed at all levels of government to detecting, investigating and prosecuting fraud that steals scarce resources from the programs that serve people in need.”

As to Ronnette Brown, U.S. Attorney Daly stressed that an indictment is not evidence of guilt.  Charges are only allegations and a defendant is presumed innocent unless and until proven guilty beyond a reasonable doubt.

This matter is being prosecuted by Assistant U.S. Attorney David J. Sheldon and Auditor Susan Spiegel.

U.S. Attorney Daly and Connecticut Attorney General George Jepsen also announced that Naimetulla Syed, M.D., a physician with a private practice in Newtown, has agreed to pay $422,641.70 to resolve allegations that Syed submitted false claims to Medicare and Medicaid.  The investigation revealed that on numerous occasions between July 2009 and December 2013, Syed billed Medicare and Medicaid for psychotherapy services using a code for individual psychotherapy lasting 45 to 50 minutes, face to face with a patient, and medical evaluation and management services.  In the vast majority of these cases, Syed saw his patients for between five and 30 minutes, at most, and did not perform medical evaluation and management services. 

This matter was handled by Assistant U.S. Attorney Anne Thidemann, and Assistant Attorney General Gregory O’Connell.

“I appreciate the continued close coordination with the U.S. Attorney and our other federal and state agency partners on cases such as this, which seek to protect Connecticut taxpayer funded public healthcare programs from fraud and abuse,” said Attorney General Jepsen.

The U.S. Attorney’s Office, Chief State’s Attorney’s Office and Attorney General’s Office meet regularly as part of The Medicaid Fraud Working Group.  The Working Group also includes representatives from the Connecticut Department of Social Services; the Connecticut Department of Public Health; the Drug Control Division of the Connecticut Department of Consumer Protection; the Office of the Inspector General of the U.S. Department of Health and Human Services, and the FBI.  The Working Group reviews pending issues and cases, identifies trends that might indicate fraudulent activity, and coordinates efforts for maximum results.

People who suspect health care fraud are encouraged to report it by calling 1-800-HHS-TIPS.