Carr: Child Behavioral Health Counselor Convicted of Medicaid Fraud

MM Curator summary

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

[MM Curator Summary]: Mr. Lacey’s shenanigans were first noticed by Wellcare. MCO fraud referrals do happen.

 
 

 
 

 
 

Clipped from: https://law.georgia.gov/press-releases/2023-09-28/carr-child-behavioral-health-counselor-convicted-medicaid-fraud

ATLANTA, GA – Attorney General Chris Carr today announced that Antonio Lacey, 47, a behavioral health counselor in Locust Grove, has been convicted of repeatedly submitting false claims to the Georgia Medicaid program for which he obtained $45,212. A Henry County Superior Court Judge sentenced the defendant to five years, with six months to be served in prison and the remainder on probation.

“Mr. Lacey used his role as a children’s counselor to defraud our state’s Medicaid program,” said Carr. “He placed personal greed above his responsibilities as a provider, and in the process, he broke the trust of Georgia families in need of services. Now he will spend time behind bars for his illegal actions, and we will continue our efforts to protect taxpayer dollars no matter the amount.”

Antonio Lacey Guilty Plea

On Aug. 15, 2023, Lacey pleaded guilty to both counts of the indictment brought by the Attorney General’s Medicaid Fraud Division:

  • Medicaid Fraud in violation of O.C.G.A. § 49-4-146.1 (b)(1)
  • False Statements and Writings in violation of O.C.G.A. § 16-10-20

Lacey paid restitution in the amount of $45,212 at the time of his plea.

Case Summary

Lacey was enrolled in Georgia Medicaid as a provider of behavioral health services for children who cannot afford care. In a routine audit of Lacey’s practice, Wellcare, a care management organization working under contract with Georgia Medicaid, reported the lack of documentation and parents’ denial of services to the Georgia Department of Community Health (DCH). DCH referred the case to the Attorney General’s Medicaid Fraud Division for further investigation. Their findings resulted in a two-count indictment against Lacey for submitting claims for which no services had been provided.

This case was investigated by Medicaid Fraud Division Investigators Ulecia Daniel and Wilner Piquant, along with Investigative Auditor Phoenecia Hunt and Intel Analyst Zwella Boyd. The case was prosecuted by Senior Assistant Attorney General Henry Allen Hibbert.

About the Attorney General’s Medicaid Fraud Division

The Attorney General’s Medicaid Fraud Division receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award totaling $4,718,240 for Federal fiscal year (FY) 2023. The remaining 25 percent, totaling $1,607,601 for FY 2024, is funded by the State of Georgia.