School Counselor Pleads Guilty To Health Care Fraud Scheme
ASHEVILLE, N.C. – Joseph Frank Korzelius, owner of Western Carolina Counseling Services and a school counselor in the Polk County school system, admitted today to defrauding the North Carolina Medicaid Program of over $400,000, by submitting false and fraudulent reimbursement claims. Korzelius, 46, of Tryon, N.C., appeared before U.S. Magistrate Judge Dennis L. Howell and pleaded guilty to one count of health care fraud.
U.S. Attorney Rose is joined in making today’s announcement by North Carolina Attorney General Josh Stein.
“The defendant abused his position as an employee of the Polk County school system to access and misuse children’s identities to enrich himself, with funds stolen from a government-funded program. His actions are reprehensible and he will be punished for them,” said U.S. Attorney Rose.
“Using children’s personal information to defraud taxpayers is unconscionable,” said Attorney General Stein. "I will not tolerate Medicaid fraud, and my office will continue to work with the federal government to bring to justice anyone who is stealing from taxpayers.”
According to court documents and today’s plea hearing, from October 2013 to November 2016, Korzelius, a Licensed Professional Counselor and a Medicaid-approved provider of mental and behavioral health services, owned and operated Western Carolina Counseling Services in Tryon, NC. Korzelius was also employed as a school guidance counselor at Tryon Elementary School in Polk County. According to court records, Korzelius identified students and their siblings from his work at Tryon Elementary and used those potential beneficiaries’ information to access these individuals’ personal information. The defendant then used that information to create and submit billings for individual psychotherapy services when, in fact, no such services were provided.
Court documents show that Korzelius had minimal documentation to support his billings for services he fraudulently represented that he provided. Further, many recipients who Korzelius billed for indicated they never sought or received services from either Korzelius or Western Carolina Counseling Services. Filed court documents show that Korzelius controlled the bank accounts where the Medicaid approved reimbursements were deposited. During the course of his scheme, Korzelius submitted over $450,000 in false claims and received $436,229.08 in reimbursements for those fraudulent claims.
Korzelius was released on bond following his plea hearing. The health care fraud charge carries a maximum prison term of 10 years and a $250,000 fine. A sentencing date for the defendant has not been set.
The investigation was handled by the North Carolina Department of Justice, Medicaid Investigations Division (MID), and was prosecuted in the Western District of North Carolina through the MID’s participation in the Western District’s joint Health Care Task Force. The Task Force is a multi-agency team of federal and state investigators, working in conjunction with Civil and Criminal Assistant United States Attorneys, dedicated to identifying and prosecuting those who defraud the health care system and reducing the potential for health care fraud in the future. The Task Force builds upon existing partnerships between agencies and its work reflects a heightened effort to reduce fraud and recover taxpayer dollars.
If you suspect Medicare fraud, please report it by phone at 1-800-447-8477 (1-800-HHS-TIPS), or email HHSTips@oig.hhs.gov. To report Medicaid Fraud in North Carolina, please call the North Carolina Medicaid Investigations Division at 919-881-2320.