PENNSYLVANIA OFFICE OF THE ATTORNEY GENERAL: CASE UPDATE: Behavioral Health Worker Charged with $211K in Medicaid Fraud Involving Autistic Children Pleads Guilty

By Press release submission | Jun 23, 2018

Attorney General Josh Shapiro announced that a Philadelphia behavioral specialist and mobile therapist charged with Medicaid fraud of more than $210,000 involving three different facilities has pleaded guilty in Delaware County Court.

Pennsylvania Office of the Attorney General issued the following announcement on June 7.

AG Shapiro: “This defendant falsified records of autistic children – and used them to scam Medicaid.”

Attorney General Josh Shapiro announced that a Philadelphia behavioral specialist and mobile therapist charged with Medicaid fraud of more than $210,000 involving three different facilities has pleaded guilty in Delaware County Court. As part of the scheme, the therapist falsified the medical records of autistic children and submitted fake claims for reimbursement.

LaGracia Burnett, 59, of Philadelphia, worked for three behavioral health providers in Philadelphia, Montgomery and Chester counties, and billed for fabricated, overlapping services between January 2013 and May 2016. During this time, she was also working as a per-diem substitute teacher for the Philadelphia School District. Burnett falsely submitted time sheets for over $211,942 in services that she did not provide to children — many of whom were diagnosed with autism. As part of her scheme to steal Medicaid funds, she falsified medical records of these children and submitted them fraudulently for reimbursement.

“When people commit Medicaid fraud, they’re stealing tax dollars from people who are in real need of these services,” Attorney General Shapiro said. “In this case, the defendant falsified the records of autistic children – and then submitted fake records to steal Medicaid funds. That’s unconscionable. We’re holding her fully accountable for her crimes. Our Medicaid Fraud Control Section is focused every day on prosecuting these kinds of cases.”

Burnett pleaded guilty in Delaware County Court this week to felony charges of Medicaid fraud, theft by deception and tampering with public records. The case is being heard in Delaware County because Burnett used a staffing agency in Haverford Township as part of her fraudulent billing scheme.

“Health care fraud is a significant problem, and directly affects Medicare and Medicaid beneficiaries, both financially and in the quality of care they receive,” said Rebecca Nurick, PA-SMP Program Manager at the Center for Advocacy for the Rights and Interests of the Elderly. “To put $211,000 in perspective, it costs an average of $971 per month to rent a two-bedroom apartment in Pennsylvania. At this rate, $211,000 could pay for 18 years of rent.”

Burnett entered her guilty plea before Judge John P. Capuzzi, Sr. Sentencing is scheduled for July 30. The investigation was led by Special Agent Chad Vigna and Analyst Courtney O’Brien and the case is being prosecuted by Senior Deputy Attorney General Elizabeth M. Madigan.

Original source can be found here.

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