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01 31 2019 14:25:11

2 more plead guilty in Sumter Early Autism Project fraud

«An embezzlement case related to Sumter-based Early Autism Project Inc. over-billing insurance companies continues as two former employees pleaded guilty earlier this month to making false claims for services that were partly or never rendered. In plea agreements dated Jan. 11 and Jan. 16 for former director of clinical services Angela Keith and co-founder Ann Eldridge, respectively, the two defendants agreed to waive indictment and arraignment and pleaded guilty to making false statements in relation to Medicaid benefits between January 2009 and June 2016. The penalty for the offense is a $1,000 fine and imprisonment for up to one year with one year of supervised release plus a special assessment of $25 for each misdemeanor charge conviction. Any monetary penalties imposed by the court will have to be paid immediately, according to the plea agreement. In exchange for the concessions made through the agreements, Keith and Eldridge waive the right to contest any conviction or sentence in a direct appeal or other post-conviction action. The Clothing Exchange The agreement also requires that Keith and Eldridge testify in front of a grand jury or during any trial when necessary. Related to the alleged fraudulent billing, Susan Butler, co-founder of EAP, also faces legal action after she was indicted on Jan. 15 for allegedly working with others to defraud Medicaid and Tricare by over-billing for autism-related and other services between January 2007 and June 2016. If she is convicted, Butler would have to repay the federal government $9,020,589.56. "Since her son, Collin, was born with autism, Susan Butler has dedicated her life to helping provide the highest quality of care to children with autism and their families," said Beattie Ashmore, Butler's attorney. "She is pleading not guilty to all charges," he said about Butler's scheduled arraignment in Columbia today. In a settlement reached on Aug. 2, 2018, EAP agreed to pay $8,833,615 to resolve a False Claims Act investigation regarding the submission of false claims to Tricare and South Carolina Medicaid programs, according to a release from the United States Attorney's Office for the District of South Carolina. The organization was accused of padding billable time for therapists who had not actively worked with children during those listed hours. The investigation started when a former employee, Olivia Zeigler, filed a lawsuit under the whistleblower provisions of the False Claims Act in July 2015. Under the act, Zeigler received $435,000 after the U.S. recovered money from the settlement.»...
Source: http://www.theitem.com | Source Status Categories: Whistle Blowing,Tendances

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01 29 2019 23:25:17

Cour de cassation: QPC 800-2 du code de procédure pénale

«Articles 470, 472, et 800-2 du code de procédure pénale Question Les articles 470, 472, et 800-2 du code de procédure pénale, en ce qu'ils interdisent ou sont susceptibles d'interdire à une personne citée directement devant le tribunal correctionnel par une partie civile, en sa prétendue qualité de civilement responsable, de solliciter, dans le cadre de l'instance où elle est ainsi attraite et dans l'hypothèse de sa mise hors de cause, la condamnation de cette partie civile au paiement de dommages-intérêts ainsi que des frais non payés par l'Etat et exposés pour les besoins de sa défense, portent-ils atteinte au droit à une procédure juste et équitable garantissant l'équilibre des droits des parties, fondé sur les article 6 et 16 de la Déclaration des droits de l'homme et du citoyen de 1789 ?» [...] «Mais attendu que la question posée, en ce qu’elle concerne l’article 800-2 du code de procédure pénale, présente un caractère sérieux en ce que l’impossibilité, pour une personne citée comme civilement responsable devant la juridiction pénale, d’obtenir une indemnité au titre des frais exposés pour sa défense dans le cas où elle serait mise hors de cause alors que la personne poursuivie ferait l’objet d’une condamnation, est de nature à porter atteinte à l’équilibre des droits des parties dans le procès pénal ; D’où il suit qu’il y a lieu de la renvoyer au Conseil constitutionnel ; Par ces motifs : DIT N’Y AVOIR LIEU DE RENVOYER au Conseil constitutionnel la question prioritaire de constitutionnalité en ce qu’elle porte sur les articles 470 et 472 du code de procédure pénale ; RENVOIE au Conseil constitutionnel la question prioritaire de constitutionnalité en ce qu’elle porte sur l’article 800-2 du code de procédure pénale ; »...
Source: http://www.courdecassation.fr | Source Status Categories: Juridique,Tendances

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01 17 2019 13:56:0

SC woman charged in alleged $9 million fraud involving autism care

«COLUMBIA ...” Federal authorities are seeking to recover $9 million that they say a S.C. woman stole in a wide-ranging scheme involving false medical bills for treating autistic children. Susan A. Butler, the "founder" of the S.C. Early Autism Project, is charged with overbilling Tricare and Medicaid, two federal health insurers, and making false claims about patient services. Money the insurers paid for patient care instead went for administrative costs, according to a federal grand jury indictment made public Wednesday. Butler "paid or caused to be paid kickbacks and bribes to clients by illegally offering free child care services for siblings," and billed Medicaid and Tricare "at higher rates than allowable for the services rendered," according to the indictment. With seven S.C. clinics, the Early Autism Project is the state's largest care center for autistic children. Its internet site says Butler founded the company in 1995. Today, it treats hundreds of children and "offers the highest quality of intensive, research-based behavioral treatment for children and young adults between 20 months and 21 years with autism spectrum and related disorders," according to its internet site. That internet site says government health insurers ...” Tricare, for active-duty military members, and Medicaid, for low-income and disabled Americans ...” will "pay for some or all" autism treatments.» [...] «Records in that case are sealed and not available to the public. However, in the August press release, the U.S. attorney’s office in Columbia said the case began when a whistleblower, former Early Autism Project employee Olivia Zeigler, brought the allegations to the government’s attention. Under the False Claims Act, a whistleblower can file a lawsuit on behalf of the government. If the government gets involved and recovers money, the whistleblower gets part of any settlement. Zeigler was paid $435,000, the U.S. attorney’s office said. »...
Source: http://eu.greenvilleonline.com | Source Status Categories: Whistle Blowing,Tendances

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