MM Curator summary
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[MM Curator Summary]: Yet another bogus MH claims fraud for $100k+. Yawn.
LAS VEGAS (KLAS) — A Las Vegas behavioral health company was ordered to pay $110,000 in restitution in a Medicaid fraud case, according to the Nevada Attorney General’s Office.
Joy Behavioral Health and its owner, Edward Gamboa, were placed on two years probation after an investigation found the company billed Medicaid for services that were not provided to Medicaid recipients. The company was sentenced on a gross misdemeanor for intentional failure to maintain adequate records.
“The investigation revealed that Gamboa, through Joy, submitted fraudulent claims to Medicaid asserting that Rehabilitative Mental Health (RMH) services were provided to recipients when in fact they were not,” according to a Friday news release.
As part of a plea deal, Gamboa was previously sentenced to probation on a charge of acting without lawful authority. Gamboa is the sole owner of Joy Behavioral Health, which has an office at 3130 S. Rainbow Blvd.
District Court Judge Eric Johnson issued the sentence.
“Our office will continue to take action against those who abuse the privilege of receiving taxpayer funds that are supposed to help Medicaid recipients,” Nevada Attorney General Aaron D. Ford said. “My office will always endeavor to bring to justice health care providers engaged in such fraudulent billing practices.”
The Nevada Medicaid Fraud Control Unit (MFCU) receives 75% of its funding from the U.S. Department of Health and Human Services under a grant award. The remaining 25% is funded by the State of Nevada MFCU. Persons convicted of Medicaid fraud may also be administratively excluded from future Medicaid and Medicare participation.
Anyone wishing to report suspicions regarding any of these concerns may contact the MFCU at 702-486-3420 or 775-684-1100.