Detroit-area resident Louisa Thompson pleaded guilty today for her role in a $16 million fraud scheme, announced the Department of Justice, the FBI, and the Department of Health and Human Services (HHS).
Thompson, 63, pleaded guilty today before U.S. District Judge Nancy D.
Edmunds in the Eastern District of Michigan to one count of conspiracy to commit
health care fraud. At sentencing, scheduled for Oct. 18, 2012, Thompson faces a
maximum penalty of 10 years in prison and a $250,000 fine.
According to the plea documents, in approximately January 2006, Thompson
began billing Medicare for psychotherapy services through two companies, TGW
Medical Inc. and Caldwell Thompson Manor Inc. The services billed by Thompson at
TGW and Caldwell Thompson were never performed or were performed by unlicensed
staff who were not authorized to perform services reimbursed by Medicare. The
unlicensed staff members also fabricated therapy notes for patients that were
never seen and billed Medicare using document templates created by Thompson.
According to court documents, Thompson also received payments from the owner
of P&C Adult Day Care Inc., a psychotherapy clinic. Those payments to
Thompson were, in part, for the use of Thompson’s provider number by P&C.
Thompson also admitted signing therapy documents for P&C patients she never
saw or treated. P&C, like TGW and Caldwell Thompson, billed for
psychotherapy services that were either not performed or performed by unlicensed
staff. Caldwell Thompson and P&C shared Medicare beneficiaries and/or
Thompson admitted to submitting or causing to be submitted approximately
$15.9 million in fraudulent psychotherapy claims on behalf of TGW, Caldwell
Thompson and P&C. Medicare paid approximately $4.9 million of those
The guilty plea was announced by Assistant Attorney General Lanny A. Breuer
of the Justice Department’s Criminal Division; U.S. Attorney for the Eastern
District of Michigan Barbara L. McQuade; Acting Special Agent in Charge of the
FBI’s Detroit Field Office Edward J. Hanko; and Special Agent in Charge Lamont
Pugh III of the HHS Office of Inspector General’s (HHS-OIG), Chicago Regional
The case is being prosecuted by Trial Attorney Gejaa T. Gobena of the
Criminal Division’s Fraud Section and Assistant U.S. Attorney for the Eastern
District of Michigan Philip A. Ross. The case was investigated by the FBI and
HHS-OIG, and was brought as part of the Medicare Fraud Strike Force, supervised
by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the
Eastern District of Michigan.
Since its inception in March 2007, Medicare Fraud Strike Force operations in
nine locations have charged more than 1,330 individuals and organizations that
collectively have billed the Medicare program for more than $4 billion. In
addition, HHS’s Centers for Medicare and Medicaid Services, working in
conjunction with the HHS-OIG, are taking steps to increase accountability and
decrease the presence of fraudulent providers.
To learn more about the Health Care Fraud Prevention and Enforcement Action
Team (HEAT), go to: www.stopmedicarefraud.gov.
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