SOCIAL WORKER PLEADS GUILTY TO
MEDICAID, INSURANCE FRAUD

Attorney 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 were provided.

The State’s 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.

Comparison 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 analysis.

The 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.

The 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.

The case was investigated and prosecuted by the Medicaid Fraud Control Unit of the Maryland Attorney General’s Office in conjunction with the Insurance Fraud Division of he Maryland Insurance Administration.

A charge 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.

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