BATON ROUGE, LA – United States Attorney Donald J. Cazayoux, Jr. announced that CARLA CLARK, age 47, and LILLIE LAVAN, age 57, both of Pineville, Louisiana, pled guilty today before Senior U.S. District Court Judge Frank J. Polozola to counts of an indictment charging health care fraud.

The indictment arose from a health care fraud scheme involving two companies known as Fusion Services, L.L.C. (“Fusion”), and Grace Social Services, L.L.C. (“Grace”), which operated in Alexandria, Louisiana and the surrounding areas. CLARK and LAVAN were Licensed Clinical Social Workers who worked with Sonya Williams, the owner of Fusion and Grace. CLARK and LAVAN participated in creating false and misleading medical records for Fusion indicating that Medicare beneficiaries had received individual, face-to-face psychotherapy when, in fact, no such services had been provided. Williams then prepared false claims for the purported psychotherapy services to elderly patients and submitted them to Medicare for reimbursement. Medicare paid Fusion and Grace approximately $349,715 as a result of the billings, much of the profits were deposited into Williams’ personal accounts.

As a result of her guilty pleas, CLARK faces a maximum sentence of imprisonment of 20 years, a $500,000 fine, or both. As a result of her guilty plea, LAVAN faces a maximum sentence of imprisonment of 10 years, a $250,000 fine, or both. The Court may also order CLARK and LAVAN to pay restitution. Sentencing has not yet been set for either defendant.

United States Attorney Donald J. Cazayoux, Jr. stated, “This plea is the result of another successful effort by the Medicare Fraud Strike Force to root out and prosecute health care fraud. Rest assured, we will continue to pursue these fraudsters who undermine our health care system. I commend our partners with the U.S. Department of Health and Human Services, the Federal Bureau of Investigation, the Internal Revenue Service, and AdvanceMed for their continued focus and diligence in finding and stopping fraud within our Medicare system.”

Assistant Special Agent-in-Charge William W. Root, Health and Human Services said, “We are proud of the outstanding work by the Medicare Fraud Strike Force. The guilty pleas today sends a message to other perpetrators that we will thoroughly investigate all allegations of health care fraud. Protecting the programs intended for our nation’s most vulnerable citizens is paramount to our mission.”

FBI Special Agent-in-Charge David W. Welker said, “Today’s guilty pleas are the result of the hard work of Agents and analysts from Health and Human Services, Internal Revenue Service – CID, the FBI as well as prosecutors from the United States Attorney’s Office. Gone unchecked conduct such as displayed by Ms. Clark and Ms. Lavan will continue to raise the cost of healthcare for every American citizen. The FBI and its law enforcement partners will continue to aggressively seek out and investigate healthcare fraud and bring to justice those perpetrators who would abuse the system.”

The investigation of this matter is ongoing, and is being conducted by the U.S. Department of Health and Human Services’ Office of Inspector General, the Federal Bureau of Investigation, the Internal Revenue Service, and AdvanceMed, the Medicare Program Safeguard Contractor which assists with health care fraud investigations. The case is being prosecuted by Assistant United States Attorneys Catherine M. Maraist and Leetra Harris.

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Posted by on Jan 24 2012. Filed under Fraud, Health Care Fraud. You can follow any responses to this entry through the RSS 2.0. You can skip to the end and leave a response. Pinging is currently not allowed.

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