PG Man Convicted of Defrauding Md. Medicaid of $366K - Southern Maryland Headline News

PG Man Convicted of Defrauding Md. Medicaid of $366K

ANNAPOLIS - Maryland Attorney General J. Joseph Curran, Jr. announced today that Gabriel W. Adelanwa, a licensed certified professional counselor and Medicaid provider of mental health services in the Prince George’s County area, was convicted of Medicaid fraud in the Circuit Court for Prince George’s County. Judge Michael Whalen sentenced Adelanwa to five years in the Division of Corrections and suspended all but nine months to be served at the Prince George’s County Detention Center on home detention. He was placed on five years of probation upon his release and ordered to pay restitution to the State Medicaid Program totaling $366,000.00. At the time of his guilty plea on November 20, he paid $183,000.00 toward restitution.

Operating his counseling business as Therapeutic Associates, Inc, Adelanwa submitted claims to, and received payment from, the Medicaid Program--totaling more than $400,000.00 within less than two years. Of that money, $366,000.00 was determined to be fraudulent.

Over the two-year period, Adelanwa repeatedly submitted claims for rendering as many as 36 to 51sessions of service per day, although each session of service is approximately 45-50 minutes. In other instances, he billed for services that were provided by two non-credentialed individuals. He submitted more than 2500 claims in which he ‘upcoded’ a 45-50 minute visit to 75-80 minutes. He also billed and received payment for group and family therapy, although there was no evidence that such services were ever rendered. Several clients said that he saw them no more than five times and then abandoned them, although he billed for rendering as many as 193 sessions of services for some of those same clients. Most of his clients were children with significant psycho-social issues and truly needed mental health services.

Adelanwa was suspended from the Medicaid program and as a provider of public mental health services in July 2004. As an additional consequence of his conviction, Adelanwa faces exclusion from the program as a Medicaid provider for a period of at least five years. The case was prosecuted by the Medicaid Fraud Control Unit (MFCU) of the Maryland Attorney General’s Office. The MFCU conducted the investigation with assistance from the Mental Hygiene Administration (MHA). MHA has been working with the MFCU to root out fraud in its programs, and several cases of possible fraudulent behavior by MHA providers are currently under investigation by the Attorney General’s Office.

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