Friday, June 4, 2010

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In Case You Missed It: Texas Attorney General, U.S. Attorney's Office Investigation Leads to Conviction of Houston Man for Health Care Fraud

(HOUSTON) – Edward Birts, of Houston, has pleaded guilty to conspiracy to commit health care fraud, health care fraud and aggravated identity theft arising from his role in a health care fraud scheme in which Medicare and Medicaid were fraudulently billed for psychiatric counseling services, U.S. Attorney José Angel Moreno and Texas Attorney General Greg Abbott announced today.

Birts, 51, owns and operates Courage to Change, a behavioral counseling company located in Houston. Birts represented himself as a doctor in psychology (PhD) when in fact he just purchased a doctoral degree online and then awarded himself several bogus professional certifications in counseling.

Birts unlawfully acquired Medicaid beneficiaries’ information, including names, addresses and Medicaid numbers which he would use to file false claims. Then, through his counseling business, Birts routinely billed Medicaid for group therapy sessions and psychiatric counseling that were not provided to the beneficiaries.

Birts regularly billed Medicaid and Medicare for psychiatric counseling services provided by himself when in fact he was not legally licensed, or even professionally qualified, as a psychiatrist, psychologist or a counselor. Finally, Birts routinely billed Medicaid and Medicare for psychiatric counseling services provided by “Dr. R. B.” on behalf of Courage to Change Inc. when in fact “Dr. R.B.” did not provide the services and was neither employed nor contracted by Courage to Change Inc.

The scheme to defraud began in January 2003 and continued through September 2006. Birts billed Medicaid and Medicare for claims totaling approximately $1,282,466.87 and received payments for those claims totaling approximately $968,583.58.

U.S. District Court Judge Vanessa Gilmore scheduled sentencing for Nov. 29, 2010. Birts faces a maximum of 10 years imprisonment and a $250,000 fine for the conspiracy conviction as well as a maximum of 10 years imprisonment and a $250,000 fine for the health care fraud conviction. Federal law also imposes a mandatory two-year terms of imprisonment for the aggravated identity theft conviction which must be served consecutive to any prison term imposed for either of the two other counts of conviction. Birts has been in federal custody since his arrest on March 3, 2010.

The investigation leading to the indictment and ultimately to today’s conviction was conducted by the Department of Health and Human Services - Office of Inspector General and the Texas Attorney General’s Medicaid Fraud Unit in Houston. Special Assistant United States Attorney Justo A. Mendez is prosecuting the case.