Treatment center duo accused of huge fraud - Insurance News | InsuranceNewsNet

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March 3, 2023 Newswires
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Treatment center duo accused of huge fraud

Providence Journal (RI)

PROVIDENCE – An addiction recovery agency with offices in Rhode Island and Massachusetts defrauded health insurers out of millions while depriving as many as 1,800 patients of vital drug treatment services, federal officials said Thursday.

U.S. Attorney Zachary A. Cunha announced those allegations hours after investigators arrested Michael Brier, 60, of Newton, Massachusetts, identified as the CEO of Recovery Connection Centers of America — and Mi Ok Bruining, 62, of Warwick, an agency supervisor with the nickname "five-minute queen," officials say, for her ability to reduce a patient's 45-minute counseling session to a bare few minutes but bill insurers for a full session.

Both are charged with committing health care fraud. Brier, a former tax preparer who was convicted of tax evasion in 2013 for underreporting more than $1.1 million in income, is also charged with aggravated identity theft, money laundering and obstruction.

The criminal complaint against Brier also alleges he pretended to be a doctor and wrote fraudulent prescriptions using the names and prescriber identity information of doctors without their permission.

"The allegations set forth in this case represent one of the most brazen and egregious examples of health care fraud the FBI has seen here in Rhode Island in recent history," Cunha said.

Company billed insurance providers for more therapy hours than exist in a day

Recovery Connection, which opened offices in 2018, is headquartered at 381 Wickenden St., Providence, with another office in Pawtucket and a dozen more locations in Massachusetts. About half of its 1,800 patients are Rhode Island residents, Cunha said.

Officials allege Recovery Connection billed Medicare and other insurers for services it never provided its patients.

For example, the company would bill for full, 45-minute counseling sessions when in fact patients received only a few minutes of counseling and treatment. And officials say Bruining trained other workers in how to fraudulently bill.

One former employee was allegedly equipped with a bell that they would ring to ensure the flow of patients moved briskly along.

Joseph Bonavolonta, special agent in charge of the FBI's Boston division, said Brier and his company are accused of accomplishing the impossible: working and billing Medicare and other insurance providers for more psychotherapy hours than exist in the day.

On one occasion, he said, Recovery Connection billed taxpayers for 38 different patients all receiving 45-minute sessions in one day – for a total of 28.5 hours.

"Most reprehensible is the fact that these alleged crimes were carried out on the backs of our most vulnerable; those struggling with substance-abuse dependencies seeking to get their lives back on track," said Bonavolonta.

"Today's charges," said Cunha, "should serve notice that we are not going to stand by in the face of this kind of fraud that victimizes a vulnerable population by shortchanging them of critical help while defendants help themselves to the federal taxpayers' money in the process."

Cunha said that Recovery Connection "should never have opened because our primary defendant, Mr. Brier, used false information to apply for federal health care funding using another individual's name and other identifying information."

The complaint alleges Brier sought to obstruct the investigation by creating a false and back-dated document to try to cover up for his past false submissions.

In an affidavit supporting the arrest warrants for Brier and Bruining, the business is described as "operating as an office-based opioid treatment program." Since April 2018, it has received more than $2.4 million in payments for claims submitted to Medicare, more than $7.2 million in payments for claims submitted to MassHealth and over $6 million for claims submitted to other health care payors, the affidavit says.

The government is seeking to seize Brier's Newton home, valued at close to $2 million, along with two vehicles: a 2020 Mercedes Benz and a 2019 Lexus. Additionally they want to seize the Recovery Connection headquarters in Providence and seek the forfeiture of 13 bank accounts.

Officials are trying

to help Recovery Connection's patients

Health officials in both Rhode Island and Massachusetts were making arrangements to assure continued treatment for Recovery Connection patients.

Rhode Island patients needing new or immediate bridge prescriptions were urged to call (401) 606-5454, while those needing behavioral health referrals for physicians or counselors or clinic information may call (401) 414-LINK.

Massachusetts patients needing prescriptions can call (617) 414-4175, and those needing behavioral health referrals for physicians, counselor, or other services can call (800) 327-5050 or use helplinema.com.

Contact Tom Mooney at: [email protected]

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