Richmond County Man Convicted of Conspiracy to Commit Medicaid Fraud
On Saturday, November 5, 2016, a Richmond County Jury convicted Carl Anthony Wardlaw, owner and operator of TWI Counseling, Inc., on one felony count of Conspiracy to Commit Medicaid Fraud (O.G.G.A. §§ 16-4-8 and 49-4-146.1(b)). Mr. Wardlaw was immediately sentenced to the maximum of five years in prison.
TWI Counseling, Inc. had locations in Vidalia, Atlanta, Albany, Augusta and Savannah.
Between February 6, 2009 and June 17, 2013, TWI Counseling, Inc. was enrolled in the Georgia Medicaid Program and purported to provide Intensive Family Intervention to children through Georgia Medicaid’s Community Mental Health program. The program’s rules and regulations expressly prohibit billing Georgia Medicaid for any services not performed and falsifying patient records.
The charges allege that Mr. Wardlaw caused fraudulent billings to be submitted to Georgia Medicaid, and that he directed employees to create fraudulent documents to support the false billings to Georgia Medicaid. This investigation also revealed that numerous psychological evaluations were backdated and forged in order to conceal that children were not approved for treatment. It further revealed that numerous individuals were paid to recruit children to TWI Counseling, Inc. in violation of 42 U.S.C. § 1320a-7b(b)(2).
As a result of these fraudulent practices, Mr. Wardlaw and TWI Counseling, Inc. accepted payments from Georgia Medicaid in excess of $3 million, which is more than they were entitled.
Employees, Janelle Lambert, Eric Johnson and Bryan Holmes all pleaded guilty to Conspiracy to Commit Medicaid Fraud at a prior date. They were each sentenced to five years of probation under the Georgia First Offender Act. The State dismissed the one count against Derrick Kimble and the jury acquitted Stephanie Wardlaw, Stephanie McCloud and Sarah Wardlaw on November 5, 2016.
Assistant Attorney General, Robin E. Daitch and Senior Assistant Attorney General, Nancy B. Allstrom prosecuted this case. The case was investigated by the Georgia Medicaid Fraud Control Unit’s former Chief Investigator Cameron Rabbitt, FBI Special Agent Anthony Deprizio, Jr. and DHHS/OIG Special Agent David Graupner. The case was also investigated by Georgia Medicaid Fraud Control Unit’s Investigative Auditor Denise Colson, Chief Analyst Carmen Staley, former Nurse Investigator Mary Murr, Forensic Analyst Tish Murray and Forensic Examiner Dane Ritcheson of DHHS/OIG.
In addition, a special thanks to the following personnel for their efforts: the Georgia Medicaid Fraud Control Unit’s trial team; Nurse Investigator Beth Ann Teague; Tracy Riles and Ronald Williams; Legal Secretary Tava Sparks; Investigator Ralph Harper, Investigator Sadarius Miley; Chief Investigator Johnny Brooks; the Department of Community Health and the Department of Behavioral Health and Developmental Disabilities.
Members of the public should keep in mind that indictments contain only allegations against the individual(s) against whom the indictment is sought. A defendant is presumed innocent until proven guilty, and it will be the government’s burden at trial to prove the defendant guilty beyond a reasonable doubt of the allegations contained in the indictment.