Former State Employee Sentenced to Prison for Role in Medicaid Fraud Scheme
John H. Durham, United States Attorney for the District of Connecticut, announced that TOSHIREA JACKSON, 50, of Bridgeport, was sentenced today by U.S. District Judge Victor A. Bolden in Bridgeport to 24 months of imprisonment, followed by three years of supervised release, for her role in a health care fraud scheme.
According to court documents and statements made in court, beginning in January 2012, Jackson and Juliet Jacob operated two businesses, Transitional Development And Training (TDAT), and It Takes A Promise (ITAP), both located at 360 Fairfield Avenue in Bridgeport, which provided social and psychotherapy services. The investigation revealed that Jackson and Jacob used ITAP and TDAT to bill Medicaid for psychotherapy services that were never provided. As part of their scheme, Jackson and Jacob used the Medicaid provider numbers of two licensed health care providers who had neither rendered nor supervised any of the psychotherapy services that Jackson and Jacob billed to Medicaid. Jackson, and the two licensed providers, were employees of the Connecticut Department of Mental Health and Addiction Services (DMHAS). The two providers did not authorize Jackson or Jacob to obtain provider numbers for them at TDAT or ITAP, and were not aware that TDAT or ITAP were billing Medicaid as if the providers had personally rendered the psychotherapy services.
The investigation further revealed that, in March 2012, Nikkita Chesney, who was employed by a health care provider that provided substance abuse treatment, including a detoxification program in Bridgeport, began to steal the personal identification information of Medicaid clients who were patients of her employer. The personal identifying information included the patients’ Medicaid identification number, Social Security Numbers and dates of birth. Jackson, Jacob, and Chesney then used the stolen identity information to bill Medicaid for psychotherapy services purportedly provided by TDAT and ITAP, when the Medicaid clients had never received any such services from TDAT or ITAP.
Jackson has admitted that the scheme involved stealing the identity of more than 150 Medicaid clients, and that she and her co-conspirators successfully billed Medicaid for approximately half of those clients. Jackson further admitted that she and her co-conspirators also billed Medicaid for services to other clients that were never provided to those clients.
Judge Bolden ordered Jackson to pay $2,496,618 in restitution.
On December 13, 2018, Jackson pleaded guilty to one count of health care fraud.
Jackson, who is released on a $25,000 bond, is required to report to prison on July 12, 2019.
On October 18, 2018, Jacob pleaded guilty to one count of health care fraud for her role in this scheme and a separate Medicaid fraud scheme. On October 23, 2018, Chesney pleaded guilty to one count of health care fraud and one count of aggravated identity theft. Both await sentencing.
Five other individuals have been charged and convicted of health care fraud offenses as a result of this and related investigations.
This matter is being prosecuted by Assistant U.S. Attorney David J. Sheldon and Auditor Susan Spiegel.
This case is being jointly investigated by the Office of the Inspector General of the U.S. Department of Health and Human Services and the Medicaid Fraud Control Unit of the Chief State’s Attorney’s Office and the Federal Bureau of Investigation, with assistance from the Connecticut Attorney General’s Office. U.S. Attorney Durham thanked the Connecticut Department of Social Services for their role in identifying the fraudulent scheme and supporting the investigation and prosecution of the case.
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.