The U.S. Attorney’s Office for the Eastern District of Pennsylvania filed a civil health care fraud lawsuit Monday, under the False Claims Act, against an Allentown husband and wife and their network of mental health centers funded largely by Medicaid and Medicare.
The lawsuit names Melchor Martinez and Melissa Chlebowski, both of Allentown, as defendants and their businesses: Northeast Community Mental Health Centers in Philadelphia; Lehigh Valley Community Mental Health Centers in Allentown, Easton and Bethlehem; and North Carolina Community Mental Health Centers in Raleigh, N.C.
The complaint notes Martinez was convicted of Medicaid fraud in 2000 and, as a result, was excluded from participating in all federally funded health care programs including Medicaid and Medicare. The exclusion prohibited Martinez from owning, managing or receiving payments from any federally funded health care provider.
The lawsuit alleges that in spite of the exclusion, Martinez, assisted by his wife Chlebowski, continued to own and operate the Northeast and Lehigh Valley clinics, and that, in 2009, while his exclusion was ongoing, he started up the North Carolina clinic in Raleigh.
The complaint also says the clinics billed Medicaid for psychiatrist visits “of very brief duration, sometimes as little as two to three minutes, while fraudulently representing that patients were being seen for a 15 minute visit.”
The Northeast and Lehigh Valley clinics allegedly billed Medicaid and Medicare for the services of “therapists” who were not qualified to provide mental health services, and fraudulently billed Medicare for therapy services allegedly provided without the required supervision.
The complaint did not specify the damages being sought by the government.
The matter was investigated by the U.S. Department of Health and Human Services’ Office of Inspector General and the U.S. Attorney’s Office for the Eastern District of Pennsylvania, with assistance from the Pennsylvania Office of Attorney General and the North Carolina Department of Justice.