Four employees of a former behavioral health provider in Carlsbad are facing felony charges, the Office of the Attorney General announced Tuesday.
From the Carlsbad Current Argus:
Attorney General Hector Balderas said Tuesday morning that Michael Stoll, Noel Clark, Darrill Woodfield and John Bain will each face several felony Medicaid fraud charges.
Bain, Stoll, Clark and Woodfield have been issued summonses to appear later this month and in June in a Carlsbad Magistrate Court, where the Attorney General’s Office filed documents charging them each with eight counts of Medicaid fraud under the Medicaid Fraud Act, one count of conspiracy and one count of fraud involving non-Medicaid funds.
Those Medicaid fraud charges include allegations of three incidents of false or excessive claims, four counts of falsification of documents, and providing substantially inadequate treatment for which they billed $20,000 in claims between January 2010 and November 2012.
Some more context from the newspaper:
The Carlsbad Mental Health Center is defunct, but services have continued to be provided under various management since October 2012, when search warrants were served by the attorney general’s office against the center. Turquoise Health and Wellness took over the center in August 2013, pulling out earlier this year for financial reasons, the company said.
The Carlsbad Mental Health Center came management of Presbyterian Medical Services and Golden Services in April.
And this interesting piece from The Associated Press:
Human Services officials saw the charges as a vindication after a highly politicized 2013 audit of mental health centers prompted the provider shake-up. The audit alleged $36 million in state Medicaid funding was mishandled by the 15 nonprofit providers.
The Human Services Department eventually replaced the nonprofits with companies from Arizona, despite protests that the due-process rights of the nonprofit providers were violated when the state froze payments without hearings.
Human Services Secretary Brent Earnest said a whistleblower tipped off state authorities about suspicious billing at the Carlsbad Mental Health Center, which led to the audit of the 15 providers. “It certainly speaks to the seriousness of the referrals,” Earnest said.
I covered this issue extensively when I was working for New Mexico In Depth. Read their archive of stories on this topic here.