Three individuals from a suburban Chicago youth counseling center, charged with defrauding Illinois Medicaid out of $2.5 million, have been handed prison sentences, according to federal authorities. Operators of Laynie Foundation Inc., Summer Matheson, and Terrence Ewing, alongside employee Richard Grundy, orchestrated a scheme between 2011 and 2018 to overbill for mental health services, far beyond what was actually provided. Their malfeasance came to light through an investigation involving various state and federal agencies.
In a detailed exposé released by the U.S. Attorney's Office, the group was also found to be charging Illinois Medicaid for non-reimbursable tasks, including case reviews and staff training. Adding to their fraudulent tactics, Matheson instructed employees to backdate and amend patient records, misrepresenting services as being reviewed and approved by a licensed practitioner, when, in reality, they had not been.
Matheson, 46, Ewing, 62, and Grundy, 39, all from Chicago, entered guilty pleas to federal healthcare fraud charges last year. Subsequently, on Thursday, U.S. District Judge John Robert Blakey sentenced Matheson to six years, Ewing to four and a half years, and Grundy to just over three years in prison. Medicaid, a lifeblood for many underprivileged families, is jointly funded by states and the federal government, with states determining their own guidelines. Illinois is no different, and these sentences underscore the serious nature of preying on such essential services.
Authorities including Morris Pasqual, Acting U.S. Attorney for the Northern District of Illinois, and FBI Special Agent-in-Charge Douglas S. DePodesta announced the sentences. "Valuable assistance in the investigation was provided by the Illinois Attorney General’s Office, Illinois State Police, and Illinois Department of Healthcare and Family Services," detailed the U.S. Attorney's Office. The prosecution was led by Assistant U.S. Attorneys Prashant Kolluri, and Charles W. Mulaney.
