Rhode Island addiction center allegedly cheated patients, stole millions - Insurance News | InsuranceNewsNet

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March 22, 2023 Newswires
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Rhode Island addiction center allegedly cheated patients, stole millions

Herald News (Fall River, MA)

PROVIDENCE – About an hour after speaking with FBI agents last month about possible health care fraud at his workplace, Regis Burlas, a doctor at a Wickenden Street drug addiction center, said his boss confronted him in the office.

"You should have kept your mouth shut," Michael Brier allegedly told him.

Later that day, Brier approached Burlas again. Court documents say he demanded Burlas sign a paper back-dated to 2018. That's when Brier – still on probation after serving prison time for tax evasion – started Recovery Connection Centers of America using Burlas as a front man.

The bogus paper gave Brier permission to use Burlas's name on financial documents and on contracts with medical insurers.

Burlas initially refused to sign it, but because he was afraid of Brier, he told investigators, he eventually did.

On March 2, federal officials charged Brier, 60, of Newton, Massachusetts, and another agency leader, Mi Ok Bruining, 62, of Warwick, with defrauding Medicare and other insurers out of millions while depriving as many as 1,800 clients in Rhode Island and Massachusetts of addiction therapy and treatment.

Brier is scheduled to be back in federal court March 23 to answer to what Joseph Bonavolonta, head of the FBI's Boston division, called "one of the more brazen and egregious examples of health care fraud the FBI has seen here in Rhode Island in recent history."

The scheme, officials say, relied on slashing the time of each client's 45-minute counseling session so the agency could cram in more appointments each day at its two Rhode Island locations and 12 others in Massachusetts, including one in Fall River. Then, the agency billed insurers for reimbursement for each client for the full 45-minute counseling session.

Just how audacious the alleged scheme was is outlined in a 63-page affidavit. And it presents a far more sinister image of Brier than the one he presents in online advertisements and interviews of an empathetic health care provider on a mission to help those struggling with addictions.

In an online promotional appearance with DotCom magazine, for instance, Brier says "Quite honestly," anyone looking for a job at his agency who is "not passionate about what we do, I'm not interested in them. If they are not willing to put the client first ahead of everything else. ... that's not a fit for me. If you don't take care of the clients, anything else you're doing here is irrelevant."

His declaration was far from the truth, the affidavit claims.

Brier and Bruining imposed a strict policy that counselors see a client for no longer than 15 minutes. Workers told investigators that Bruining earned the nickname "five-minute queen" for her perfunctory client sessions, and that she brushed off concerns raised by some counselors about whether what they were doing was legal.

"Do the insurance companies know clients aren't being seen for 45 minutes?" one worker asked Bruining in an email on Nov. 9, 2019. "I just want to make sure this is all on the up and up. I don't want to accidentally participate in fraud ...."

Bruining replied that the insurance companies were reimbursing Recovery Connection for 45-minute clinical counseling increments "regardless of whether the sessions are 15 minutes or 1 hour, so we bill as 45 minutes."

But the worker wrote he was worried because he was creating two contradictory sets of documents — his actual notes, which accurately reflected his seeing a new client every 15 minutes, and what the agency wanted him to have submitted for reimbursement. He suggested the billing process more accurately reflect the 15-minute sessions.

"Please do not fix something that ain't broke," Bruining replied in her email. "This system works for both Michael and me, please do not change it."

Insurance companies begin to catch on

Counselors weren't the only ones who began asking questions about the billing process.

So, too, did insurance companies.

In response to a 2020 billing inquiry from Blue Cross & Blue Shield of Rhode Island, Brier falsely claimed in an email that counseling sessions at Recovery Connection Centers of America (RCCA) routinely lasted at least 45 minutes, the affidavit says.

"Many times, RCCA's counselors find that they must routinely provide a minimum of 45 minutes of counseling to their patients and, in fact, find it very difficult to limit a counseling session to 45 minutes in light of the complications and behavioral health issues that RCCA's patients are suffering."

Brier stressed the agency's firm commitment to its clients.

"The counselor cannot limit RCCA's patients to less than 45 minutes in light of the disease they have, the other co-conditions and complications they suffer ... RCCA will continue to spend the necessary amount of time with its patients, regardless of whether or not BCBSRI ultimately pays" for the full sessions.

Bonavolonta called Brier's alleged actions "reprehensible."

Brier hid his tax-fraud conviction to open the recovery center

When Brier started Recovery Connection Centers of America in 2018, he filed a fraudulent Medicare provider application listing Burlas as "the sole owner," says the affidavit.

That allowed Brier to hide his 2013 conviction for not reporting more than $1.1 million in income and for violating a federal judge's order that barred him from preparing tax returns for others.

Had he reported the conviction as required in his Medicare provider application, it would have disqualified him from opening the agency.

Burlas has not been charged with any crime.

(Burlas is identified as Dr. #2 in the affidavit and also as the president, vice president, treasurer and secretary of the agency for years 2019-2022, as he is in incorporation papers filed with the secretary of state's office.)

Brier allegedly pretended to be a doctor, wrote prescriptions

Brier's health care fraud went beyond bilking insurance companies, the affidavit says.

He also pretended to be a doctor at times, writing prescriptions for patients when the agency's real doctors were unavailable.

When one of the agency's doctors went on a three-week cruise at the end of 2018, Brier wrote at least 55 Suboxone prescriptions for patients using the doctor's federal identification information, the affidavit states.

When Burlas returned and the office manager told him what had happened, he fired off an angry email to Brier.

"It is against the law for a layperson to practice medicine, and that is actually what you were doing," the doctor wrote. "The patients did not realize that you were not a physician, and many referred to you as one. I think you know this. You gave them prescriptions with my signature, or a proxy for it" – an illegal act that jeopardized Burlas's medical license.

Brier didn't respond to the email, but Burlas said he was subsequently "let go."

Burlas told investigators he was so concerned about Brier using his medical information to write prescriptions that he began issuing additional prescriptions to patients if he knew he would be out of the office.

Brier also faces charges of identity theft, money laundering and obstruction. His lawyer, Anthony M. Traini, declined to comment for this story. A lawyer for Bruining was not listed in court papers.

Randal Edgar, a spokesman for the state Department of Behavioral Healthcare, Developmental Disabilities & Hospitals, says the actions of the leaders of Recovery Connection are alarming; "We are thankful for the Department of Justice's quick action."

Edgar said his department "is always concerned when individuals authorized to provide care abuse the trust of their patients, families and the public."

Joseph Wendelken, spokesman for the Department of Health, said the incident is "certainly a great concern to us, because we never want to see anything jeopardize patient care ... We would certainly be supportive of additional scrutiny going forward to make sure that treatment facilities are administered by people who have patients' best interests in mind."

When he appeared in the online promotional appearance with DotCom magazine, Brier said repeatedly that health care businesses must learn to treat addiction-recovery patients with greater respect.

"If client care is not your number one priority," he said, "you're probably not going to wind up to be successful in business."

Contact Tom Mooney at: [email protected]

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