Morris woman sentenced for health care fraud

MORRIS >> Anne Charlotte Silver, 63, of Morris, was sentenced Monday by U.S. District Judge Victor A. Bolden in Bridgeport to 10 months of imprisonment, followed by three years of supervised release, for committing health care fraud, according to a statement from Deirdre M. Daly, United States Attorney for the District of Connecticut.

Patricia Lafayette of Torrington, a co-conspirator in the fraud, was sentenced to 21 months in prison on April 27. She was ordered to provide 100 hours of community service upon her release from prison, and to pay restitution of $1.6 million.

According to court documents and statements made in court, in March 2011, Silver was a licensed clinical social worker who owned and operated Silver Counseling Services, LLC, in Canton and Bantam.

In March 2011, Silver agreed with Patricia Lafayette and another individual to engage in a scheme to defraud Medicaid, in which Silver permitted Lafayette and the other individual to bill Medicaid for licensed psychotherapy services using Silver’s Medicaid provider number. The services were either performed by unlicensed individuals or not performed at all. Under the scheme, Silver kept 25 percent of the proceeds, and paid the remaining 75 percent to Lafayette and the other individual.

Over the next four years, Lafayette submitted more than 18,000 false claims for psychotherapy using Silver’s provider number. The claims included more than $71,000 in false claims for psychotherapy services purportedly provided to Lafayette’s daughter and grandchildren, and more than $67,000 in false claims for psychotherapy services provided to Lafayette’s son’s girlfriend and her children, according to the statement.

“All of these claims represented that Silver personally provided the psychotherapy services, which was not true,” the statement reads.

In addition, Silver did not supervise Lafayette or the services that Lafayette was billing, did not know who purportedly provided the service, and never verified that the services had in fact been rendered, according to the statement. Twice a month for four years, Silver received the payment for these services from Medicaid, calculated Lafayette’s 75 percent share of the scheme, and met with Lafayette to deliver a check for that amount, officials said.

On May 2, 2016, Silver pleaded guilty to one count of health care fraud for her role in the scheme. As part of her plea, Silver admitted to defrauding Medicaid of more than $1.6 million, of which Silver received more than $300,000.

Lafayette pleaded guilty to the same charge.

Lafayette’s son, Maurice Sharpe, pleaded guilty to the same charge on Dec. 13, 2016. He is scheduled to be sentenced on June 19.

The criminal case was jointly investigated by the Office of the Inspector General of the U.S. Department of Health and Human Services and the Medicaid Fraud Control Unit of the Chief State’s Attorney’s Office, with assistance from the Connecticut Attorney General’s Office. Daly thanked the Connecticut Department of Social Services for their role in identifying the fraudulent scheme and supporting the investigation and prosecution of the case.

The U.S. Attorney’s Office, Chief State’s Attorney’s Office and Attorney General’s Office meet regularly as part of the Medicaid Fraud Working Group, she said. The working group also includes representatives from the Connecticut Department of Social Services; the Connecticut Department of Public Health; the Drug Control Division of the Connecticut Department of Consumer Protection; the Office of the Inspector General of the U.S. Department of Health and Human Services, and the FBI. The working group reviews pending issues and cases, identifies trends that might indicate fraudulent activity, and coordinates efforts for maximum results, she said.

This matter is being prosecuted by Assistant U.S. Attorney David J. Sheldon and Auditor Susan Spiegel.

People who suspect health care fraud are encouraged to report it by calling 1-800-HHS-TIPS.