Addiction treatment center supervisor admits to participating in a scheme to defraud federal, state, and private health care insurers

 

Date: November 9, 2023

Contact: newsroom@ci.irs.gov

Providence, RI — A clinical social worker today admitted to a federal judge that she helped devise and execute a scheme that shortchanged Rhode Island and Massachusetts substance abuse disorder patients out of counseling and treatment services while, at the same time, defrauding Medicare, Medicaid, and other health insurers out of more than $3.5 million dollars, announced United States Attorney Zachary A. Cunha.

Mi Ok Song Bruining of Warwick, admitted that, while employed as a supervisor at Recovery Connections Centers of America, Inc. (RCCA) in Providence, she and others working at her direction routinely submitted false and fraudulent claims for psychotherapy and counseling services that did not occur for the length of time billed, consistently billing for far more patients than was possible for RCCA staff to have seen during office hours. Bruining, known at RCCA as the "5 Minute Queen" for her speed in seeing patients for so-called counseling sessions, admitted that while billing for 45-minute sessions she actually saw patients for no more than 5-10 minutes, at times asking patients only one question before she ended a session.

According to information presented to the court, to facilitate this fraud, Ms. Bruining directed counselors and others at RCCA to record in their notes that they were providing counseling in 45-minute intervals, but without listing AM or PM for the start time. Ms. Bruining gave this instruction so that it was not clear that they were seeing more patients than possible within a single hour. She also instructed other counselors to copy and paste the last visit's note into each entry to make the bill look complete. As a result, many of the patient notes for patients billed by RCCA were simply identical cut-and paste copies of the same note.

Bruining pleaded guilty to a charge of conspiracy to commit health care fraud. She is scheduled to be sentenced on February 15, 2024. The defendant's sentence will be determined by a federal district judge after consideration of the U.S. Sentencing Guidelines and other statutory factors.

The case is being prosecuted by Assistant United States Attorneys Sara Miron Bloom and Kevin Love Hubbard.

The matter was investigated by the U.S. Department of Health and Human Services, Office of Inspector General and the Federal Bureau of Investigation. United States Attorney Cunha thanks the IRS criminal Investigation (CI), Customs and Border Protection, and the Rhode Island Office of the Attorney General for their assistance in the investigation.

CI is the criminal investigative arm of the IRS, responsible for conducting financial crime investigations, including tax fraud, narcotics trafficking, money-laundering, public corruption, healthcare fraud, identity theft and more. CI special agents are the only federal law enforcement agents with investigative jurisdiction over violations of the Internal Revenue Code, obtaining a more than a 90 percent federal conviction rate. The agency has 20 field offices located across the U.S. and 12 attaché posts abroad.