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Date: 03-11-2021
Case Style:
Case Number: 3:21-cr-00038-VLB
Judge: Vanessa L. Bryant
Court: United States District Court for the District of Connecticut (New Haven County)
Plaintiff's Attorney: United States District Attorney’s Office
Defendant's Attorney:
Description: New Haven, Connecticut health care fraud charge criminal defense lawyer represented Defendant, Wali Muhammad, 45, of Branford, who was charged with one count of health care fraud.
According to court documents and statements made in court, from 2010 to 2019 Muhammad owned and operated Happy Family Clinical Services LLC (“Happy Family”), a mental health and social services agency. At various times, Happy Family’s office was located in East Haven and Branford, before moving to New Haven in 2014.
From 2013 through 2019, Muhammad engaged in a scheme to defraud the Connecticut Medicaid Program by submitting fraudulent claims for psychotherapy services that were purportedly provided to Medicaid clients. The claims were for occasions and dates of service when no psychotherapy services of any kind had been provided to the Medicaid clients identified in the claims. The claims also were submitted using the names and identities of licensed clinical social workers and other licensed health care providers who purportedly worked for Happy Family, and represented that the psychotherapy services were personally rendered by the licensed providers, when, in fact, the licensed providers had not personally rendered the services, had not supervised the services that were billed, and were unaware that Muhammad was billing or causing the services to be billed as if the providers had personally rendered the services. When services were provided, they were usually rendered by unlicensed individuals and billed as licensed psychotherapy.
Muhammad faces a maximum term of imprisonment of 10 years. As part of his plea, Muhammad agreed to pay $574,034 in restitution to Medicaid.
This case has been investigated by Special Agents of the Office of the Inspector General of the U.S. Department of Health and Human Services (HHS-OIG), and Police Inspectors from the Medicaid Fraud Control Unit (MFCU) of the Connecticut Chief State’s Attorney’s Office. Acting U.S. Attorney Boyle also thanked the Connecticut Attorney General’s Office, the Connecticut Department of Social Services, and the Connecticut Department of Mental Health and Addiction Services for their assistance in the investigation.
The matter is being prosecuted by Assistant U.S. Attorney David J. Sheldon and Auditor Susan Spiegel.
The U.S. Attorney’s Office, Chief State’s Attorney’s Office, and Attorney General’s Office meet regularly as part of The Medicaid Fraud Working Group. The Working Group also includes representatives from the Connecticut Department of Social Services; the Connecticut Department of Public Health; the Drug Control Division of the Connecticut Department of Consumer Protection; the Office of the Inspector General of the U.S. Department of Health and Human Services, and the Federal Bureau of Investigation. The Working Group reviews pending issues and cases, identifies trends that might indicate fraudulent activity, and coordinates efforts for maximum results.
HEALTH CARE FRAUD
(1)
Outcome: Defendant pleaded guilty.
Plaintiff's Experts:
Defendant's Experts:
Comments: