Brenda Ward, Health Care Fraud, Texas 2015

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Dallas Woman Sentenced for Medicaid Scam

DALLAS – Brenda Ward, 48, of Cedar Hill, Texas, was sentenced to 57 months in federal prison and ordered to pay $887,809 in restitution to Medicaid, following her guilty plea in July 2015 to one count of health care fraud.

U.S. Attorney John Parker of the Northern District of Texas made the announcement today. Judge Sidney A. Fitzwater ordered Ward to surrender to the Bureau of Prisons on March 8, 2016.

According to documents filed in the case, Ward, who was President and CEO of H.E.L.P.-Ing. Communities, Inc. (HCI), obtained a Medicaid group number for HCI and used that number, together with individual Medicaid provider numbers of licensed counselors and Medicaid recipient information, to submit fraudulent claims to Medicaid.

A federal investigation found that Ward, who is neither a psychotherapist nor a mental health provider, submitted claims for individual, family, and group psychotherapy sessions that were not performed. She used the Medicaid provider numbers of four licensed counselors, without their knowledge and consent, to submit claims under the HCI group number for services that they did not perform.

The scheme also involved the use of the Medicaid provider information of a fifth licensed counselor who worked for her to submit claims for psychotherapy services that both predated and postdated the counselor’s actual employment with her, as well as claims for services that the counselor did not provide during the counselor’s employment. Ward used the identification of more than 290 Medicaid recipients, most of whom were minor children, in her scheme.

Ward admits that from January 1, 2009, through February 9, 2015, she personally submitted fraudulent claims to Medicaid and to Medicaid Managed Care Organizations, through HCI, totaling approximately $1,639,923; Ward was paid approximately $887,809 for these claims.

The FBI, the U.S. Department of Health and Human Services – Office of Inspector General and the Texas Attorney General’s Medicaid Fraud Control Unit investigated. Assistant U.S. Attorney Douglas Brasher prosecuted.

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