Idaho woman admits to submitting false claims for reimbursement on behalf of refugees
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The following is a news release from the U.S. Attorney’s Office (Idaho).
BOISE – U.S. Attorney Josh Hurwit announced that KA Health Services (KA Health) and its owner, Khalid Ameri, paid $321,576.51 to resolve allegations that they knowingly submitted or caused the submission of false claims to Medicaid for psychotherapy, language interpretation, and other services. The United States contended that these submissions were false because the claimed services were never provided and/or not provided by a qualified professional.
As a result of the same investigation, licensed professional counselor Karen Canfield, 61, of Boise, consented to a judgment against her in United States District Court after admitting to violations of the False Claims Act. Canfield admitted to knowingly causing KA Health to submit false or fraudulent claims to Medicaid for reimbursement for psychotherapy, language interpretation, and other services.
According to court records, Canfield admitted that she knew that KA Health’s clients were refugees that recently arrived in the United States and were not fluent in English. Rather than treat KA Health’s clients, Canfield directed language interpreters – who were not licensed or otherwise qualified to provide psychotherapy services – to meet with the clients without Canfield being present or otherwise participating in the meeting. Canfield further admitted that she filled out their medical records in a false or fraudulent manner because those records indicated she had provided services when she was not, in fact, meeting with KA Health’s clients – much less providing them with therapy. Canfield later signed the false medical records, which she knew KA Health then used as the basis for submitting claims to Medicaid for reimbursement.
“The vast majority of Idaho’s health care providers play by the rules. Our office is committed to rooting out the few wrongdoers, particularly those that prey on vulnerable patient populations,” said U.S. Attorney Josh Hurwit. “Healthcare fraud enforcement is and will remain an important priority for our office. We will not tolerate individuals and businesses who compromise the integrity of the healthcare system for financial gain.”
“These resolutions demonstrate our commitment to protecting Idaho communities from schemes targeting Idaho’s Medicaid program, which provides necessary services to some of the most vulnerable populations in the state,” said Special Agent in Charge Steven J. Ryan with the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG). “HHS-OIG values our continued partnership with the Idaho Medicaid Fraud Control Unit and our other law enforcement partners, and will continue to investigate fraud allegations, which threaten the integrity of both federal and state health care programs and the people served by them.”
These matters were investigated jointly by the U.S. Attorney’s Office for the District of Idaho, the Office of the Inspector General of the U.S. Department of Health and Human Services, and the Idaho Attorney General’s Office’s Medicaid Fraud Control Unit. Additional assistance was provided by the Idaho State Department of Health and Welfare. Assistant U.S. Attorney Elliot Wertheim handled the cases.