U.S. District Judge Tilman E. “Tripp” Self III on Thursday ordered Middle Georgia Family Rehab (MGFR) healthcare clinic in Macon, Georgia, to pay $9,617,679.22 in damages after the court found the business to be involved in fraudulent TRICARE and Medicaid claims.
“The ‘reckless disregard’ displayed by Middle Georgia Family Rehab in its billing should serve as a warning to other health facilities across Georgia – and the nation – that filing improper and false claims will come with hefty consequences,” U.S. Attorney Peter D. Leary said in a statement about the case.
Judge Self issued his judgement in the civil suit U.S. v. Middle Georgia Family Rehab (MGFR) after an evidentiary hearing took place on Tuesday, May 24th. The case regarded the fraudulent bills of hundreds of Medicaid and TRICARE claims by the Macon-based health clinic.
“Middle Georgia Family Rehab (MGFR) reaped hundreds of thousands of dollars from taxpayers by improperly filing claims with agencies designated to provide physical therapy and speech therapy services to children and military families. A strong team effort from our Civil Division and its investigative partners resulted in a significant judgment against Middle Georgia Family Rehab which reinforces that our community’s most deserving patients are entitled to quality healthcare services,” Leary said.
In a partial summary judgement on April 20th, the court determined in this particular False Claims Act case that MGFR and its owner, Brenda Hicks, filed some 800 false Medicaid and TRICARE service claims. The bills were submitted improperly and used the names of both a speech therapist and physical therapist who were no longer employees of MGFR at the time, “and therefore could not possibly have provided the services in question.”
“When Medicaid providers fraudulently divert funds for personal gain, not only does it undermine the needs of those who are most vulnerable, but the taxpayers of Georgia are harmed as well,” Georgia Attorney General Chris Carr said.
The court found that MGFR’s actions over an eight-month period epitomized “‘reckless disregard’ of the truth.” The near-800 false claims submitted to TRICARE and Medicaid followed the resignation of a physical therapist, and 41 of the false claims submitted followed the resignation of a speech therapist.
The court determined the false insurance claims “could not be characterized as an ‘honest mistake.'”
“Middle Georgia Family Rehab was charged with providing trusted health services to our military families and children in need, and it failed to fulfill its responsibilities by instead choosing to exploit the system. This type of deceptive behavior is entirely unacceptable, and those who abuse our publicly funded healthcare programs will be held accountable,” Carr said.
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Addison Basurto is a reporter at The Georgia Star and The Star News Network. Follow Addy on Twitter and GETTR. Email tips to [email protected]
Photo “Middle Georgia Family Rehab” by Middle Georgia Family Rehab.