Miami Woman Pleads Guilty to 2 Charges for Role in $63 Million Health Care Fraud Scheme: Authorities

Alina Feas, 53, pleaded guilty to one count each of health care fraud and conspiracy to commit health care fraud, authorities said

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    NBC Local Media

    A former health care clinic director from Miami pleaded guilty Tuesday for her role in a $63 million fraud scheme, authorities said.

    Alina Feas, 53, pleaded guilty to one count each of health care fraud and conspiracy to commit health care fraud in connection with the scheme involving the defunct health provider Health Care Solutions Network Inc.

    Feas appeared before U.S. District Judge Cecilia Altonaga in the Southern District of Florida. Her plea was announced in a statement Wednesday by U.S. Attorney Wifredo Ferrer and officials from the Justice Department, FBI and the Department of Health and Human Services’ Office of Inspector General.

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    During the conspiracy, Feas worked as a therapist and clinical director of Health Care Solutions Network’s Partial Hospitalization Program, which provides intensive treatment for severe mental illness, authorities said.

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    The organization operated two community mental health centers in Florida and one in North Carolina. Feas oversaw the clinical program, supervised therapists and other personnel for HCSN in Florida, and also conducted some group therapy sessions, authorities said.

    Feas was aware that HCSN in Florida paid illegal kickbacks to the owners and operators of assisted living facilities in Miami-Dade County, receiving in return patient referral information to be used to submit fraudulent Medicare and Medicaid claims, according to court documents. She also knew that many of the assisted living facility referral patients were ineligible for Partial Hospitalization Program services, the documents said.

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    Feas submitted claims to Medicare for therapy she purportedly provided to HCSN in Florida patients using her own Medicare provider number, knowing that HCSN in Florida was simultaneously billing the same patients for Partial Hospitalization Program services, court documents said. HCSN in North Carolina also submitted fraudulent Partial Hospitalization Program claims while Feas billed Medicare under her personal provider number, according to the documents.

    Feas was aware that HCSN personnel in Florida were fabricating patient medical records, many of which were used to support fraudulent billing to government health care programs including Medicare and Medicaid, and she signed fabricated Partial Hospitalization Program therapy notes and other records used to support false claims, authorities said.

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    Feas also knew that co-conspirators in North Carolina were fabricating medical records to support the fraudulent claims she was causing to be submitted to Medicare, authorities added.

    Health Care Solutions Network billed Medicare and the Florida Medicaid program about $63 million for purported mental health services between 2004 and 2011, according to court documents.

    Thirteen of the 15 people charged in the health care fraud scheme have pleaded guilty, with another trial scheduled to begin June 3, authorities said.

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