May 19, 2021
Las Vegas, NV – Today, Nevada Attorney General Aaron
D. Ford announced that Lavell James Worthy, Jr., 34, of Las Vegas, was
sentenced in a Medicaid fraud case involving the failure to maintain adequate
records. The false claims were submitted to Nevada Medicaid between March 1 and
December 23, 2017.
The Honorable Judge Michael A.
Cherry sentenced Worthy to 364 days in jail, suspended, and placed Worthy on
probation. As a part of his sentence, Worthy was ordered to pay $100,000 in
restitution. Individuals or businesses convicted of Medicaid fraud may also be
administratively excluded from future Medicaid and Medicare participation.
“Worthy intentionally misused the
Medicaid reimbursement system for his own gain,” said AG Ford. “My
office will not allow Medicaid providers to cheat Nevada out of resources
reserved for vulnerable individuals. Providers, be on notice that my office will
continue to aggressively prosecute these crimes to protect those in need of
these services.”
The investigation of this case
began after the Attorney General’s Medicaid Fraud Control Unit (MFCU) received
information that Worthy, the owner of Spirit of David Behavioral Health, LLC,
was using his business to submit false claims for services that were never
actually provided to Medicaid recipients. The investigation revealed that Worthy
failed to maintain documentation necessary to substantiate claims billed to
Nevada Medicaid. For the minimal documentation that was preserved, many of the
notes indicated Medicaid recipients no longer wanted to receive services;
however, Worthy, through the operation of Spirit of David, continued to submit
claims to Medicaid for payment under these recipients alleging that his company
provided them with services.
The MFCU
investigates and prosecutes financial fraud by those providing healthcare services
or goods to Medicaid patients. The MFCU also investigates and prosecutes instances
of elder abuse or neglect. The Nevada MFCU receives 75 percent of its funding
from the U.S. Department of Health and Human Services under a grant award. The
remaining 25 percent is funded by the State of Nevada, MFCU. Anyone wishing to
report suspicions regarding any of these concerns may contact the MFCU at
702-486-3420 or 775-684-1100.
This case
was investigated by the Attorney General’s Medicaid Fraud Control Unit and prosecuted
by Senior Deputy Attorney General Behnaz Salimian Molina.
To view the
criminal information of Lavell James Worthy, Jr., click here. To file a complaint
with the Office of the Nevada Attorney General, click here.
WORTHY,
LAVELL JAMES, JR.
(Photograph
Courtesy of the Las Vegas Metropolitan Police Department)
###