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Baton Rouge doctor adds guilty plea to others in Medicare case

Health care providers understand how complex Medicare rules are. Billing departments are required to stay on top of law changes and restrictions to avoid triggering a fraud investigation accidentally. Federal Medicare fraud investigators, prosecutors and criminal defense lawyers also can't do their jobs without extensive knowledge of the intricacies of Medicare laws.

Federal officials have been investigating an alleged Baton Rouge fraud case for three years. Seventeen people associated with two clinics were charged with conspiring to bilk Medicare out of tens of millions of dollars. More than half a dozen defendants pleaded guilty to taking part in the health care scheme, including a psychiatrist and co-owner of one of the clinics.

The mental health professional recently entered a guilty plea to fraud charges related to the Shifa Community Mental Health Center and Serenity Center. The former office manager at both facilities last year admitted she played a large role in facilitating the $37.9 million scam.

Investigators alleged -- and the former office manager confessed -- that hundreds of people ineligible for outpatient psychiatric care were bussed to the clinics. Prosecutors said the "patients" were vulnerable older people, individuals with chronic mental health disorders and drug addicts. Medicare allegedly was billed for therapy services the clinics either failed to give or provided inappropriately to the bussed-in patients.

In court, the psychiatrist claimed he was guilty for making "errors in judgment." Earlier in the investigation, the doctor admitted he accepted psychiatric patients from outside Louisiana but asserted the patients were referred to the Baton Rouge clinics. The ex-office manager declared she falsified clinic records and encouraged other clinic workers to do the same to hide the fraudulent activities.

Sometimes, an accused person pleads guilty simply out of fear of punishment. Plea deals seem like safer bets than trials with unknown conclusions. A defense attorney can help clients avoid knee-jerk reactions and pursue the optimum legal path.

Source: The Advocate, "Psychiatrist says he’ll plead guilty in Medicare fraud case" Bill Lodge, May. 10, 2014

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