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Cuccinelli, MacBride announce sentencing of Richmond in-home therapy provider for $325,000 in Medicaid fraud
RICHMOND (June 4, 2012)-- A Richmond man has been sentenced today for defrauding Medicaid out of more than $325,000 by billing for medically unnecessary intensive in-home (IIH) therapy services designed to assist youth who are at risk of being removed from their homes, or who are being returned to their homes after removal because of significant mental health, behavioral, or emotional issues. Attorney General Ken Cuccinelli and U.S. Attorney for the Eastern District of Virginia Neil MacBride made the announcement today that Michael Griffin, 37, of Richmond, was sentenced by Judge Henry E. Hudson of the U.S. District Court for the Eastern District of Virginia to 24 months in prison, followed by three years of supervised release. In addition, Griffin was ordered to pay $325,980 in restitution to the Virginia Department of Medical Assistance Services, the state agency charged with overseeing the Medicaid program in Virginia
Griffin served as the intensive in-home program director for First Class Living Center, LLC, an IIH therapy provider. According to court documents, from about March 15, 2010, through about December 14, 2011, First Class was located and operated in Richmond. First Class was licensed through the Commonwealth of Virginia and under contract with Medicaid to provide IIH services.
As the intensive in-home program director, Griffin submitted prior-authorization documentation to initiate IIH services for Medicaid recipients. Griffin made false statements on prior-authorization forms and, as a result, First Class defrauded the Medicaid program by billing at least $325,980 for medically unnecessary IIH services.
This case was investigated by Virginia's Office of the Attorney General's Medicaid Fraud Control Unit with assistance from the Office of Inspector General, U.S. Department of Health & Human Services. Assistant Attorney General of Virginia and Special Assistant United States Attorney Joseph E.H. Atkinson, and Assistant United States Attorney Jessica Aber Brumberg prosecuted the case on behalf of the United States.
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