SPOKANE, Wash. — Ray Smith, a Spokane mental health counselor, has agreed to pay $138,984 to resolve allegations that he and his company fraudulently billed Washington State Medicaid, according to a press release from the Spokane US Attorney's Office
The US Attorney's Office says Smith’s company, A Brief Counseling Center (ABCC), employed several mental health treatment providers, billing Washington State Medicaid to cover their services. Those providers were then discovered to be unlicensed and unqualified.
“Mental health services are a vital component of a safe and strong community, and our public funding for those services is a precious and limited resource,” United States Attorney Vanessa R. Waldref said. “Fraudulently billing the public for unqualified and unlicensed therapy services provided to some of the most vulnerable members of our community is simply unconscionable, and will not be tolerated.”
Washington State Medicaid is funded by federal and state taxpayers and provides health insurance for low-income Washington residents. In this case, it can provide reimbursement for treatment services provided by qualified and licensed providers who are a part of the state Health Care Authority.
According to court documents, Smith improperly billed Medicaid for therapists working at ABCC who were unlicensed and unqualified. They did not meet the requirements for receiving Medicaid, were not contracted by the state and therefore were not eligible for reimbursement through the program, the US Attorney says.
The case began back in November 2019 after two whistleblowers who used to provide billing services for ABCC filed a qui tam complaint under seal. This kind of complaint requires an investigation by the United States to decide whether intervention is necessary.
It was decided intervention was necessary this month and the settlement was obtained, according to the US Attorney.
The $138,984 settlement resolves the allegations under the False Claims Act, according to the press release. It also resolves the allegations of fraudulent billing and misrepresentation of services provided by licensed and qualified therapists.
“To pose as qualified mental health professionals in order to claim Medicaid dollars is unethical, dangerous, and unlawful,” Washington Attorney General Bob Ferguson said. “I am proud of our collaboration with our federal partners, and the hard work it took to bring this company to justice.”