(Insurance Journal) - The owner of a chain of clinics treating substance abuse disorders in Massachusetts and Rhode Island, and one of the company’s employees, were charged last week with cheating health insurers out of millions of dollars while depriving patients of needed services, federal prosecutors said.
Michael Brier, 60, the owner of Recovery Connection Centers of America, Inc., was arrested at his home in Newton, Massachusetts – and charged with health care fraud, aggravated identity theft, money laundering and obstruction, U.S. Attorney for Rhode Island Zachary Cunha said at a news conference.
Mi Ok Bruining, 62, of Warwick, the company’s former supervisory counselor, was charged with health care fraud, Cunha said. She is alleged to have hired and trained counselors on how to fraudulently bill insurers.
The company, which has two locations in Rhode Island and more than a dozen in Massachusetts, was also charged.
An email seeking comment was sent to Brier’s attorney. No defense attorney was listed for Bruining in court documents.
It is alleged that “under the guise of running recovery clinics that supposedly provided much needed medical and therapy services to men and women in Rhode Island and Massachusetts who needed help in their struggles with addiction, these defendants in fact shortchanged their patients, providing them with little or no therapy and support while at the same time billing Medicare and other insurers as if they had,” Cunha said.
They billed public and private insurers for 45-minute treatment sessions that were in fact often 15 minutes or less, he said. Sometimes they billed insurers for more sessions than there were hours in the day.
Bruining was even called the “”five minute queen” for the short length of her therapy sessions, Cunha said.
About 1,500 patients in total were affected, authorities said.
Brier, who is not a doctor, used the names of real doctors in order to use their license numbers without their knowledge or permission to fill prescriptions for some patients, authorities said.
Brier also allegedly lied on his Medicare application by failing to disclose a 2013 federal tax evasion conviction that led to a 27-month prison sentence.
Joseph R. Bonavolonta, special agent in charge of the FBI Boston division, called the case “one of the most brazen and egregious examples of health care fraud the FBI has seen here in Rhode Island in recent history.”
The FBI seized Brier’s nearly $2 million home, two late-model cars, and the company’s Providence headquarters. Brier tried to conceal and launder the proceeds of his scheme through investment accounts, the purchase of luxury vehicles, student loan payments, home renovations, and an oceanfront resort in Panama, Bonavolonta said.
Federal authorities are working with the Rhode Island Department of Behavioral Healthcare, Developmental Disabilities and Hospitals and the Massachusetts Department of Public Health to ensure continuity of care for RCCA’s patients.