COLUMBUS — Former Riverside Recovery executive director Amy Smart has pleaded guilty to falsifying Medicaid bills for counseling and case management services that weren’t provided.
Smart entered the plea on Oct. 16, according to the U.S. District Court for Southern Ohio records.
The charges state Smart 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.
Before Smart’s sentencing, a presentence investigation report will be completed. Smart’s attorney, Michael Jason Hunter, has until Oct. 30 to object to the report and recommendation.
When Knox Pages requested a comment on the case, Hunter declined. Attempts to reach Riverside Recovery executive director Flint Postle for comment were unsuccessful.
Smart’s sentencing date has not yet been set.
According to the statement of facts document, in 2018, the Ohio Attorney General’s Office, Medicaid Fraud Control United (MFCU) received numerous complaints regarding improper billing associated with Riverside Recovery Services.
Also according to the statement of facts, MCFU and Health and Human Services investigation revealed that Smart was over-billing the Ohio Medicaid Benefits Program for alcohol and drug treatment services.
Authorities say the investigation involved numerous patient and employee interviews, as well as a review of patient records, billing records and emails, all of which demonstrated that Smart was engaged in billing fraud at Riverside.
Smart and Riverside Recovery were misrepresenting the type and length of counseling services provided to patients, according to the statement of facts. Smart, a counselor herself, was billing for case management sessions while she was on vacation, according to the statement of facts, also noting numerous employees interviewed indicated Smart directed them to “pad” counseling services and create fraudulent progress and case management notes to support these increased billings.
Additionally, Smart directed staff to bill transportation services as case management services, which is prohibited, including having staff use the word “assisted” in place of “transported” in the patient files, according to the statement of facts.
Finally, employment documents showed Smart and Riverside Recovery were billing for alleged counseling services even when patients were at work and not present at Riverside Recovery, according to the statement of facts.
According to the plea agreement, Smart is ordered to pay $345,093 in restitution to the Ohio Medicaid Program. In addition, both parties agreed to probation, the length of which will be determined by the court.
The judge may accept, reject or defer the plea agreement until it has reviewed the presentence investigation report, according to the plea agreement.