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June 08, 2018

Philly behavioral health worker pleads guilty in $211,000 Medicaid fraud

Investigation Fraud
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A Philadelphia behavioral specialist and mobile therapist pleaded guilty this week to submitting more than $211,000 in fake claims for reimbursements for treatments she claimed to provide to autistic children at three regional health facilities.

State prosecutors said LaGracia Burnett, 59, worked for health providers in Philadelphia, Montgomery and Delaware counties between January 2013 and May 2016. She was also working as a per-diem substitute teacher for the School District of Philadelphia.

During this time, investigators said Burnett billed for fabricated, overlapping services, falsely submitting time sheets for $211,942 in services she never provided to children. To execute her scheme, Burnett falsified the medical records of her would-be patients and submitted them for reimbursement.

“When people commit Medicaid fraud, they’re stealing tax dollars from people who are in real need of these services,” Attorney General Josh Shapiro said.

Burnett pleaded guilty in Delaware County Court this week to felony charges of Medicaid fraud, theft by deception and tampering with public records. The case was heard in Delaware County because Burnett used a staffing agency in Haverford as part of her scheme to submit false claims.

“Health care fraud is a significant problem, and directly affects Medicare and Medicaid beneficiaries, both financially and in the quality of care they receive,” said Rebecca Nurick, program manager at the Center for Advocacy for the Rights and Interests of the Elderly. “To put $211,000 in perspective, it costs an average of $971 per month to rent a two-bedroom apartment in Pennsylvania. At this rate, $211,000 could pay for 18 years of rent.”

Burnett is scheduled for sentencing on July 30.