COLUMBUS — A grand jury indicted former Riverside Recovery director Amy Smart on Medicaid fraud, among other healthcare charges on Thursday.
According to the indictment at the U.S. District Court, Southern District of Ohio, Smart was charged with healthcare fraud and 12 counts of healthcare false statements.
Smart’s attorney Michael Hunter declined to comment on the case.
The indictment states Smart knowingly and willfully executed a scheme to defraud a healthcare benefit program, in this case Medicaid.
Smart would bill for drug treatment counseling sessions that were not performed or not performed as billed from July 2, 2018, to Jan. 7, 2023, the indictment states.
In this scheme, Smart misrepresented and directed other Riverside Recovery employees to misrepresent the type and length of substance abuse counseling services provided to Riverside Recovery patients, according to the indictment.
Riverside Recovery was a counseling center that provided alcohol and drug counseling and case management services at three offices located in Knox, Lawrence and Coshocton counties, the indictment states.
The counseling center also had sober living homes occupied by clients.
Directed by Smart, Riverside Recovery employees “padded” counseling services and created fraudulent progress and case management notes to support increased Medicaid billings, the indictment states.
According to the indictment, Smart also billed or caused others to bill for alleged counseling services provided to patients who were actually working at the time the services were supposedly rendered.
In counts 2 through 13 of the indictment, it shows the billed services or items involved with the scheme that weren’t provided.
Eight of the services billed were alcohol and/or drug services; case management, according to the indictment. Four were for psychotherapy with a patient. The 12 submitted bills range from August 2020 to April 2022, according to the indictment.
What happened before Smart’s indictment?
In March, Federal Judge James L. Graham denied Smart’s plea deal worked out between federal prosecutors and Smart’s attorney.
According to the former plea agreement, Smart was ordered to pay $345,093 in restitution to the Ohio Medicaid Program. In addition, both parties agreed to probation, the court would have determined the length.
According to a Columbus Dispatch article, Graham pointed out Smart had a history of similar crimes, including a past conviction, probation, and a prison sentence in the early 2000s.
From past court documents, Hunter withdrew the plea deal after Graham’s ruling.
According to a previous Knox Pages article, the prosecutor planned to indict Smart after the denied plea deal.
According to the previous statement of fact used in Smart’s previous case, she knowingly falsified and submitted bills to the Ohio Medicaid program for counseling and case management services that weren’t provided from July 2, 2018, to Jan. 7, 2023, totaling $345,093.
Smart’s arraignment date hasn’t been set, according to the case’s docket.
