$600K fraud draws prison
Counselor billed Tenncare for no service
A Collierville mental health professional who admitted to charging TennCare as much as $600,000 for counseling she never performed for wayward youths and others was sentenced Tuesday to three years in a federal prison.
Mechell Debronett Toles, 44, whose clients consisted mainly of referrals from Shelby County Juvenile Court, pleaded guilty in March to federal health care fraud, a felony, but asked for probation.
Her husband, a Memphis police officer, sat in court during the hearing but didn’t speak. In a letter sent to the judge, he described his wife of 19 years as “the backbone” of their family and a devoted mother to their two children.
Toles, who remained seated during the hearing because of an undisclosed health problem, didn’t speak in court but prepared a statement read aloud by her attorney, Lorna McClusky.
“I feel too overwhelmed and ashamed” to speak in court, she wrote. “I have no viable reason for committing fraud. I did not need anything.”
U.S. Dist. Judge Jon McCalla, however, said court records detailed her debt, including unpaid taxes.
Toles’ letter expressed “sorrow” for the impact on patients, her children and husband, who has recently taken on two extra jobs.
But Asst. U. S. Atty. John Fabian read statements Toles made to investigators, saying she overbilled “more than I can even understand. ... It was just easy to do. It did not seem
harmful to others.”
The prosecutor said the fallout from Toles’ failure to counsel troubled youths is impossible to measure, but he pointed to a few cases.
In one case, Toles falsely claimed she held 29 sessions with a teen referred to her after assault and disorderly conduct charges. He later was convicted as an adult for robbery and sentenced by McCalla to nearly 10 years in a federal prison.
Another youth Toles pretended to counsel 35 times ultimately was charged with aggravated robbery and first-degree murder in a beating death.
A third juvenile who was supposed to receive 43 counseling sessions from Toles is serving an eightyear prison sentence for aggravated robbery.
Toles’ attorney agreed there was “collateral damage” but said no one can prove a link between the youths’ future crimes and the lack of intervention by Toles.
Juvenile Court officials referred 571 troubled youths to Toles from 2005 to 2012 for behavioral problems ranging from drug addiction and uncontrollable anger to sexual misconduct, said Larry Scroggs, the court’s chief administrative officer. In the majority of the cases, handled at her offices at 324 Poplar View Pkwy. in Collierville and 2693 Union Ext. in Memphis, the services would have been paid for by TennCare, which is about 70 percent federal dollars and about 30 percent state money.
And, at least 21 times, Toles billed for more than 24 hours of counseling for the same day. In some cases, Toles billed for dozens of appointments that predated the time the patients were first referred to her.
Agents watched Toles during a two-day period in which she billed TennCare for 15 sessions for individuals and 15 for families at a rate of $40-$50 per session. During that time, only three juveniles walked in to Toles’ office building, the prosecutor said.
An audit revealed the scam began around January 2009 and ended in March 2012. Juvenile Court stopped referrals to Toles in June 2012, Scroggs said.
On her LinkedIn page, Toles still lists herself as a “psychologist at Family Solutions Counseling.” The Tennessee Department of Health’s website describes her as an “active” licensed professional counselor with no known blemishes.
Toles is currently an adjunct professor for University of Phoenix, the judge said.
Prosecutors had lobbied for a sentence of three years and one month, the maximum under federal guidelines for someone like Toles, a first offender who cooperated with the government.
McCalla sentenced her to three years in custody and three years of supervised probation, along with the full $602,000 in restitution.
“She did it over and over for three years,” he said. “This is not a sudden lapse of judgment.”
Davis Schuler, whose staff of five at Juvenile Court’s Evaluation and Referral Bureau linked about 750 juveniles to services last year, sent 41 youths to Toles. Court officials don’t know to what degree Toles treated these juveniles.
“Can I condone what she did? Absolutely not,” Schuler said. “Did she help some of our kids? Absolutely, she did.
“She was willing to work hard with some of our very, very difficult kids. Not everyone wants to work with our population or takes TennCare.” In Mitchell’s Corner subdivision near Olive Branch, site superintendent Steve Reeves (right), with Keith and David Grant Homes, checks the progress of a presold home with Mike Ward on Tuesday.