Billing the government for “ghost clients”, fabricating paperwork for patients who don’t really come in and luring patients from the street by handing out cash, cigarettes and snacks are just a few of the schemes being used to defraud Medicare and Medicaid in drug rehab clinics. The information on the fraud was gathered by The Center for Investigative Reporting and CNN and involved thousands of pages of government records and dozens of interviews with counselors, patients and regulators.
In California’s Medi-Cal program, clinics were found to have padded client rolls by diagnosing people with addictions they don’t have. In addition, they rounded up mentally ill residents from board and care homes to sit in therapy sessions they can’t even understand. There is little or no government oversight which relies on the honor system.
The investigation also found billing for people who were no longer alive or who had never come to the clinics. Clinics in two cities would fill their rosters with van loads of children from group homes. Many of them had no drug or alcohol problems.
Jeffrey Newman represents whistleblowers