Vestavia Hills Psychology Clinic Employee Sentenced In Fraud Case

Birmingham AL

17 November, 2020

12:29 PM

Description

BIRMINGHAM, AL — A former employee of a Birmingham area psychology clinic who pleaded guilty to fraud charges was sentenced in federal court Tuesday. Heidi Robertson, 35, was sentenced to 18 months in prison and ordered to pay $850,000 in restitution. Robertson was employed as the primary insurance billing official for Capstone Medical Resources, LLC in Vestavia Hills. The owner of the facility, former Birmingham psychologist Sharon D. Waltz, pleaded guilty in 2019 to defrauding Medicaid. Waltz is scheduled to be sentenced by Judge David Proctor on December 10. Court records show Robertson and Waltz billed the Medicaid Agency for counseling services that were never provided. An investigation was initiated by the Program Integrity Division of the Alabama Medicaid Agency after an audit showed that billings submitted by Capstone for counseling services had increased from $99,000 in 2015 to more than $2 million in 2017. The Program Integrity Division referred its findings to the Attorney General's Medicaid Fraud Control Unit after Waltz submitted falsified records during the Program Integrity Audit. A subsequent investigation was conducted by the Medicaid Fraud Control Unit and the U.S. Department of Health and Human Services Office of Inspector General. This investigation determined that most claims submitted by Capstone from 2016 to 2018 were fraudulent. According to U.S Attorney Prim Escalon, Robertson's role in the scheme included submitting claims using the Medicaid identifications of friends' and family members' children for counseling services that never took place. Waltz paid Robertson a 10 percent commission for all claims paid by Medicaid. Robertson was employed by Waltz from 2016 through late 2017. 'Robertson's actions demonstrated reckless disregard for at-risk youth, and she will now face the consequences of those actions," Escalona said. "Today's sentence represents the relentless commitment by the U.S. Attorney's Office and our law enforcement partners to protect the resources dedicated to the members of our community that are the most vulnerable, our children."