Medicaid Provider Agrees to Lifetime Exclusion from Medicaid
RICHMOND, Va. – The owner of several Richmond area medical support service companies has agreed to settle a civil fraud case alleging her companies defrauded the Virginia Medicaid program of over $1 million.
The allegations involved Dawn Sykes, 43, of Glen Allen, and her companies: Open Arms Family Support Services, LLC; Open Arms Family Day Treatment Support Services, LLC; and Open Arms Mental Health Support Services, LLC. Sykes owned and operated all three companies from 2010 to 2017, which covers the time the Government alleged multiple fraudulent schemes, including: 1) Submission of claims to Medicaid for reimbursement of services not provided; 2) Sykes’ payment of kickbacks to an individual to induce client referrals; and 3) Submission of claims to Medicaid for reimbursement for services provided to ineligible recipients.
Sykes reached a settlement agreement providing for an initial payment of $50,000 and a consent judgment of $1,061,613 to resolve an action commenced under the False Claims Act and the Virginia Fraud Against Taxpayers Act. Sykes also agreed to lifetime exclusion from the Virginia Medicaid Program. Sykes may satisfy the consent judgment through periodic payments totaling a lesser amount.
Sykes and the above mentioned companies were named defendants in a lawsuit filed under the “whistleblower” provisions of the federal False Claims Act and the state Virginia Fraud Against Taxpayers Act. The federal and state false claims acts permit the Government to investigate the whistleblower’s allegations and to intervene or to join the litigation. Following a joint investigation, the Government intervened.
The False Claims Act and Virginia Fraud Against Taxpayers Act also permit whistleblowers to receive a share of any recovery. The whistleblower in this case will receive 18 percent of the monies paid by the Defendants. The case is captioned United States ex rel. Susana Mulcahey v. Open Arms Family Support Services, LLC, Civil No. 3:14 cv 316.
The resolution in this matter was the result of a coordinated effort between the U.S. Attorney’s Office for the Eastern District of Virginia and the Office of the Attorney General for the Commonwealth of Virginia Medicaid Fraud Control Unit. The matter was investigated by Assistant Attorneys General Ray Bowman, Airen Adamonis, Jessica Mackenzie, Candice Deisher, Adele Neiburg, and Assistant U.S. Attorney Robert McIntosh.
The Virginia Department of Medical Assistance Services assisted in the investigation.
A copy of this press release may be found on the website of the U.S. Attorney’s Office for the Eastern District of Virginia.