United States Attorney Richard B. Roper
Northern District of Texas

FEDERAL GRAND JURY INDICTS LICENSED PROFESSIONAL COUNSELOR
ON HEALTH CARE FRAUD CHARGES

LUBBOCK, TX. — A federal grand jury in Lubbock has returned a 24-count indictment charging Debra Smith, 39, with 12 counts of health care fraud and 12 counts of making false statements related to health care matters, announced U.S. Attorney Richard B. Roper of the Northern District of Texas. Smith, a former resident of Lubbock, now resides in San Gabriel, California. Although an arrest warrant was issued, it is anticipated that she will surrender to federal authorities.

According to the indictment, Debra Smith was licensed by the Texas Department of State Health Services as a Licensed Professional Counselor. In December 2001, she became a Medicaid-approved provider. One of the types of assistance available to Medicaid recipients is counseling services. Medicaid recipients are authorized to receive 30 counseling sessions per year. If a patient needs additional sessions, the provider must submit a request to Medicaid to authorize additional services.

Beginning in January 2003 and continuing until the end of 2005, Smith filed, and caused to be filed, Medicaid reimbursement claims for counseling services that were never performed. As a result, Medicaid paid Smith more than $70,000 for fraudulent and undocumented claims.
As part of her scheme to defraud Medicaid, Smith used the names and Medicaid numbers of actual and former clients, and the names and Medicaid numbers of the family members and relatives of actual and former clients, to bill the Texas Medicaid program for counseling sessions, services, and benefits that were never performed or provided.

An indictment is an accusation by a grand jury and a defendant is presumed innocent unless proven otherwise. If convicted, however, each count of health care fraud carries a maximum statutory sentence of 10 years in prison and a $250,000 fine and each count of making false statements related to health care matters carries a maximum statutory sentence of five years in prison and a $250,000 fine. Restitution may be ordered.

1 U.S. Attorney Roper praised the excellent investigative work of Texas Attorney General Greg Abbott’s Office - Medicaid Fraud Unit and the Federal Bureau of Investigation (FBI) and said, “This case is the culmination of a thorough investigation conducted by General Abbott’s Medicaid Fraud Unit and the FBI. Our cooperative efforts with the Attorney General’s office and the FBI are crucial to ferreting out and prosecuting this type of case.”

The case is being prosecuted by Special Assistant U.S. Attorney Amy R. Burch of the Texas Attorney General’s Office.

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