South West Michigan couple accused of Medicaid fraud related to family counseling business

South West Michigan couple accused of Medicaid fraud related to family counseling business

The Niles couple started the business in 2013, the release said. The business is still in existence but is not in good standing with the state of Michigan as of March 2019, per records.

The husband is facing 22 felony counts of Medicaid fraud – false claim. The wife is facing 17 felony counts of the same charge. Each count carries a four-year penalty.

Those alleged patients were contact during the investigation and said they were never counseled by the man, the release said.

The wife worked as a biller for a different medical office, where she got patient information and billed Medicaid for counseling sessions provided by Highland Counseling Center, according to the attorney general’s office.

Story Highlights

  • The man was a licensed marriage and family counselor, while his wife worked as officer manager, administrator and biller at Highland Counseling Center in Niles, Michigan Attorney General Dana Nessel said in a news release.

  • The couple is scheduled for arraignment on the charges on Oct. 13. MLive does not name criminal defendants until they have been arraigned.

The alleged fraudulent billing happened between 2018 and 2020, the AG’s office said. The woman is accused of back-billing to 2017 when she obtained the patient information in 2018.

The attorney general’s office was alerted to the case in 2020 when an organization tried to collect for services that were not provided.

“Billing Medicaid for services never provided takes valuable public resources away from those who need it,” Nessel said in the release. “My Health Care Fraud Division will continue to investigate and pursue allegations of fraud in this critical program.” More from MLive:

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