August 7, 2013
Defendants Double Billed for Equine Facilitated Therapy
Reno, NV – Nevada Attorney General Catherine Cortez Masto today announced that Suzanne Pindell, 64, of Fork of Salmon, California, and Terra Shepherd, 44, of Chico, California, and the behavioral health company they owned, HealTherapy of Nevada, were each sentenced today for a misdemeanor offense of submission of false Medicaid claims for a scam that double billed for equine facilitated therapy.
“Fraudulent Medicaid schemes will not be tolerated,” said Masto. “We will prosecute and punish those who engage in these schemes in order to protect the integrity of the Medicaid system.”
District Court Judge Lidia Stiglich adjudicated each of the defendants guilty and ordered payment of restitution, penalties and costs of $30,000, to be paid between them.
In August 2010, the Attorney General’s Medicaid Fraud Control Unit (MFCU) received information that HealTherapy of Nevada (HTN), a behavioral health company owned and operated by Pindell and Shepherd, was billing Medicaid for services it had apparently provided, but was doubling the amounts of its claims. Medicaid provides payment to behavioral health companies who provide mental health services such as substance abuse services, medication management and rehabilitative mental health services. These rehabilitative mental health services include therapy and other interventions designed to teach constructive cognitive and behavioral skills.
Further investigation by the MFCU revealed that HTN would commonly provide only one hour of service to a client but would bill Medicaid as if it had provided two hours of service. HTN provided “equine facilitated therapy,” by which it would incorporate the use of horses in the treatment of clients. HTN sought to justify the additional health care billing with client transportation, note writing and horse maintenance. HTN and its owners were aware that this billing scheme was improper but still billed Medicaid for the added time – without revealing that the full two hours of service were not being provided with the Medicaid recipients.
Persons convicted of Medicaid fraud may also be administratively excluded from future Medicaid participation.
The case was investigated and prosecuted by the Nevada Attorney General’s MFCU, which investigates and prosecutes financial fraud by those providing healthcare services or goods to Medicaid patients. The case was prosecuted by Matthew Jensen, Senior Deputy Attorney General.
The MCFU unit also investigates and prosecutes instances of elder abuse or neglect. Anyone wishing to report suspicions regarding any of these concerns may contact the Medicaid Fraud Control Unit in Carson City (775) 684-1191 or in Las Vegas (702) 486-3187. Medicaid fraud information can also be found on the Attorney General’s web site: http://ag.nv.gov/.