Former Birmingham clinic biller pleads guilty to fraud charge

Alabama News

MONTGOMERY, Ala. (AP) — A former clinic worker in Alabama has pleaded guilty for her participation in a scheme authorities say defrauded the state’s medicaid agency of at least $1.5 million by billing for counseling services that weren’t provided.

Heidi Elizabeth Robertson, of Birmingham, entered her plea on one count of conspiracy to commit healthcare fraud, authorities, including U.S. Attorney Prim Escalona and Alabama Attorney General Steve Marshall said in a news release Wednesday.

Robertson, 35, was the primary biller for Capstone Medical Resources LLC, a phycology clinic in Birmingham that filed the false claims for services they claimed to have been provided to individuals and at-risk youth, the release said. Authorities launched an investigation into the clinic after seeing an increase in the billings submitted by the facility.

During the course of their investigations, authorities found the majority of the claims submitted from 2016 to 2018 were fraudulent, the release said. Officials said Robertson submitted the false claims, and the owner of the clinic, Sharon D. Waltz, gave her 10% commission on all the claims paid by Medicaid.

Waltz, a former psychologist, pled guilty to fraud charges last year and is awaiting sentencing in federal court.

“Let this be a warning to medical billers around the State of Alabama that if you facilitate the submission of fraudulent claims, you will be held accountable for your actions,” Derrick L. Jackson, special agent in charge for the Office of Inspector General of the U.S. Department of Health and Human Services, said in the release.

Robertson was employed at the clinic from 2016 through late 2017, the release said. It was not immediately clear if she had a lawyer who could comment on her behalf.

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