A Brief Counseling Center / Healthy Counseling Center (Dr. Ray Smith)

Spokane, WA 2017--2021 Behavioral Health
DOJ OIG Medicaid Fraud False Claims
Penalty
$138,984

Outcome

Dr. Ray Smith and his Spokane counseling center settled for $138,984 to resolve fraudulent Medicaid billing allegations brought by the Eastern District of Washington.

Details

A Brief Counseling Center / Healthy Counseling Center (Spokane, WA) — Medicaid Billing Fraud

Outcome: Settled for $138,984 to resolve fraudulent Medicaid billing allegations for improper claims submitted to Washington State Medicaid.

Dr. Ray Smith, operating a mental health counseling practice in Spokane, Washington under the names A Brief Counseling Center and Healthy Counseling Center, submitted fraudulent claims to Washington State's Medicaid program. The Eastern District of Washington pursued both criminal and civil enforcement actions before reaching a settlement for $138,984, announced February 25, 2022.

Primary Source: Spokane Mental Health Counselor Agrees to Pay More Than $135,000 for Fraudulent Medicaid Billing

How Crucible Prevents This

Crucible's billing-integrity controls for mental health counseling would flag claims that do not meet Washington Medicaid documentation requirements; a pre-submission audit gate checking session documentation, time records, and counselor credentials against billed service codes would prevent fraudulent billing at the individual practice level.

Source: Spokane Mental Health Counselor Agrees to Pay More Than $135,000 for Fraudulent Medicaid Billing

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