U.S. Department of Labor Investigation Uncovers Healthcare Fraud, Leads to 71-Month Sentence for Florida Recovery Residence Owner
BOYNTON BEACH, FL – Following a U.S. Department of Labor investigation, the U.S. District Court for the Southern District of Florida has sentenced Albert Samukia Jones-Saye, the owner of a substance abuse recovery residence, to 71 months in prison and three years of supervised release. The sentencing is in addition to $2,071,406 in court-ordered restitution by Jones-Saye following a previous guilty plea to conspiring with others to commit healthcare fraud.
The Department’s Employee Benefits Security Administration (EBSA) investigation - in conjunction with federal, state, and local authorities - found that Jones-Saye committed fraud while operating a series of Palm Beach County recovery residences under the corporate names No Drug Zone, Carter Care Recovery, and A T Way.
Investigators determined that as part of its recovery program, Jones-Saye required residents to travel three times per week to attend treatment sessions at Reflections Treatment Center in Margate, and to submit to drug tests that were later billed to insurance plans. When residents failed to attend, he and his co-conspirators had Reflections employees forge its residents’ signatures on sign-in sheets. Jones-Saye’s actions led to referrals for more than 100 residents to Reflections and other treatment centers, for which he received more than $230,000.
“Healthcare fraud victimizes the individuals involved and the community at-large,” said EBSA’s Regional Director Isabel Colon, in Atlanta. “Fraudulently inflating healthcare bills for unnecessary or non-existent treatments passes the costs on to others wishing to obtain health insurance. The Department of Labor remains committed to ensuring that benefits are not abused, and anyone found guilty of committing fraud is held accountable.”
The investigation was a combined effort of EBSA, the FBI, the IRS, the Amtrak Office of the Inspector General, the Office of Personnel Management-Office of the Inspector General, the Florida Department of Insurance Fraud, the Martin County and Palm Beach sheriff’s departments, and other local police departments.
Employers and workers can reach EBSA toll-free at 866-444-3272 for help with problems related to private sector retirement and health plans. Additional information can be found at http://www.dol.gov/ebsa.