May 21, 2003
Sean Caine, 410-576-6357
WORKER PLEADS GUILTY TO
MEDICAID, INSURANCE FRAUD
General J. Joseph Curran, Jr., announced today that Barbara Andreadis,
58, of Berkeley Springs, West Virginia, pleaded guilty yesterday
to one count of felony Medicaid fraud and one count of felony insurance
fraud. The guilty plea was the culmination of a 15-month investigation
that revealed that Andreadis defrauded the Maryland Medicaid program
of $145,000 and various private health insurers of over $17,000
by billing for services that were not rendered or for which reimbursement
was not appropriate. Andreadis plea was accepted by Judge
Donald E. Beachley of the Circuit Court for Washington County. A
pre-sentence investigation was ordered and it is anticipated that
sentencing will occur in late July 2003.
Andreadis, a licensed certified social worker, previously operated
Crossroads Behavioral Therapy Center in Hancock, where she provided
psychotherapy services to her patients. From April 1999 through
December 2001, Andreadis billed and instructed her employees to
bill Medicaid for multiple services regardless of what services
States investigation revealed that there were a number of
billing practices whereby the defendant defrauded the Medicaid program
and private insurers by making false representations regarding claims
for payment. Often, the billing process employed resulted in duplicate
and triplicate billings. From May 1, 2000 through November 19, 2001,
the defendant submitted over 5200 billings indicating that services
were rendered to her patients. Of these 5200 billings, there were
only 160 single billings.
of individual insurance company billing records with Andreadis
office records revealed many instances where the defendant billed
private insurers for therapy sessions that either never took place
or were conducted by unlicensed and untrained individuals. Interviews
with numerous former and present patients corroborated this documented
defendant employed a number of individuals whom she assigned to
perform hands-on face to face social work services. These individuals
were not licensed nor did they possess any qualifications to perform
psychotherapy or social work services. Several of these employees
were in fact former patients of Andreadis. These employees saw patients
and made notations in their medical charts. On some occasions, diagnoses
were even rendered by these employees and on numerous occasions,
these employees saw patients when the defendant was not present
at the office, yet the defendant billed for these sessions.
defendant would also routinely bill Medicaid if an appointment was
canceled or if the patient failed to show up for an appointment.
In fact, the defendant often billed Medicaid for multiple services,
i.e. family, individual and/or group, when the appointment was canceled
and the patient did not receive any services.
case was investigated and prosecuted by the Medicaid Fraud Control
Unit of the Maryland Attorney Generals Office in conjunction
with the Insurance Fraud Division of he Maryland Insurance Administration.
of felony Medicaid fraud is punishable by a maximum sentence of
five years in prison and a $15,000 fine. Felony insurance fraud
is punishable by a maximum sentence of 15 years and a fine of $10,000.