Psychologist Serena Joslin pleads guilty to $63 million Medicaid fraud scheme

August 7, 2012

An Asheville, N.C., psychologist pleaded guilty earlier this month in Miami district court to submitting more than $63 million in fraudulent claims to Medicare and Medicaid in Miami, Fla., and Hendersonville, N.C.

Serena Joslin, 31, admitted to participating in a fraud scheme operated through Health Care Solutions Network (HCSN), which operated partial hospitalization programs (PHPs), or intensive mental health treatments for severe mental illness, in Miami and Hendersonville.

HCSN obtained Medicare beneficiaries by paying kickbacks to owners and operators of assisted living facilities (ALFs) or by recruiting them from nursing homes, according to the U.S. Attorney’s Office of the Southern District of Florida. The beneficiaries went to HCSN for PHP treatment that was unnecessary and, in many instances, not provided, authorities reported.

Joslin said she was aware that HCSN recruited patients who were inappropriate for PHP treatment.

She also agreed with other HCSN employees to fabricate therapy notes and other medical records, and to direct other therapists to do the same to make it appear as if HCSN patients received appropriate PHP services.

Authorities said Joslin was aware that fraudulent claims to Medicare would be submitted on behalf of these patients.

Joslin faces a maximum of 10 years in prison and a $250,000 fine at her sentencing, scheduled for Jan. 11, 2013.

Eight other charged defendants allegedly involved in the scheme, including the owner and operators of HCSN, await trial.

Source: Jaime L. Brockway, "N.C. psychologist admits to $63 million Medicare, Medicaid fraud," Insurance and Financial Advisor, July 24, 2012.