Speech therapists diagnose and treat patients that have communication and swallowing disorders resulting from strokes, brain injuries, hearing loss, developmental delays or other problems. Their job is to create and implement a treatment plan that will improve the patient’s quality of life. An article posted on YourHoustonNews.com provides details about a health care scam directed by the owner and operator of a children’s speech therapy clinic in Houston. (Her bogus treatment plans caused two health insurance companies to be billed for more than $3.7 million in fraudulent claims.)
Even though the article states that the owner and operator of the speech therapy clinic was a licensed speech therapist, she behaved unethically by lying about the availability of her clinic’s equipment and supplies required for the treatment of a swallowing dysfunction. (The equipment and supplies did not exist at all, even though her claims showed they did.) The woman and an accomplice continued to submit falsified claims to two insurance companies, though neither she nor any of her employees provided the documented treatments to her patients.
Over a period of four years, the owner and an employee submitted more than $3,784,642 in fraudulent claims. In fact, the article states that the two co-conspirators also submitted claims for various medical and speech therapy services that were not medically necessary nor provided, under the insurance of an unsuspecting employee. (They even forged a letter to one of the insurance companies providing a false address so the employee would not discover the fraudulent claims.) The fraudster’s clinic was paid more than $1.2 million for the false claims.
The 44-year-old owner pleaded guilty to one count of conspiracy to commit health care fraud and five counts of health care fraud. (Note that the speech therapy clinic owner is currently in custody due to violating the terms of her pre-trial release.) At her sentencing, the clinic owner will face up to 10 years in prison plus a maximum fine of 250,000. The 31-year-old accomplice, who is scheduled to be sentenced, also pleaded guilty to conspiracy and health care fraud.
I’d like to say it isn’t so, but unfortunately, even fraudsters go after the youngest and most vulnerable members of our society. Because of her company’s fake claims, there were children that did not receive the services that they needed and deserved. Her selfish acts not only decreased the quality of life for her patients, but will also soon impact her own life as she faces the reality of a lengthy prison term.