Husband and Wife Convicted of Defrauding
State Medicaid Program of $900,000

BALTIMORE, MD (March 11, 2008) – Attorney General Douglas F. Gansler today announced the conviction of Tammy D. Smith and Anthony H. Smith, husband and wife, both of Huntshire Road in Randallstown on nine counts of felony Medicaid fraud and nine counts of felony theft. Each count of theft carries a maximum sentence of 15 years and each count of Medicaid fraud caries a maximum sentence of five years incarceration. Sentencing has not yet been scheduled.

The evidence in the case established that Tammy Smith, a clinical social worker, and her husband, who handled her billing, submitted thousands of false claims to the Maryland Medicaid program for therapy services that were not performed at all or were different than the services billed for. For example, Ms. Smith billed for services she claimed to have performed on several days when she was a hospital inpatient. She also billed for nine months of multiple therapy services a week for a patient she never saw and who was in the hospital at the time the services were allegedly rendered. She also claimed to have provided up to 42 hours of service on a single day and more than 24 hours of service per day on 27 separate occasions.

During the trial, several former employees testified that they were told to falsify billing documents in an effort to bill a higher rate to Medicaid. In addition, several former patients testified that they did not receive the services that were billed to the Medicaid program by the Smiths. The evidence also established that Ms. Smith billed for thousands of 75 minute therapy sessions that were not performed at all or were actually only 20 to 30 minute sessions. The State established that from January of 2000 through December of 2003, Medicaid paid the Smiths nearly $900,000. Although required to do so by the Medicaid regulations, the Smiths failed to document over $700,000 of those services.

“My Office will pursue criminally any provider who tries to defraud the State Medicaid program,” said Attorney General Gansler, noting that the Medicaid program is one of the largest items in the State budget. “This kind of fraud hurts both needy patients by wasting Medicaid’s strained resources and the State itself by stealing from the taxpayers.”

The case was prosecuted by the Attorney General’s Medicaid Fraud Control Unit with the assistance of the Mental Hygiene Administration and the Medicaid Program, both of which are part of the Department of Health and Mental Hygiene.