New Bedford Social Worker Pleads Guilty, Sentenced to Jail for Defrauding $160,000 From State Medicaid and Medicare Programs
Defendant to Serve Nine Months in House of Correction; Ordered to Pay Restitution
NEW BEDFORD – A clinical social worker from New Bedford has pleaded guilty and been sentenced to jail today in connection with a scheme to defraud state’s Medicaid and Medicare programs of more than $160,000 for services not provided, Attorney General Martha Coakley announced today.
David M. Benson, age 50, of New Bedford, pleaded guilty in Bristol Superior Court to charges of Larceny Over $250 (14 counts), and Medicaid False Claims (7 counts). Benson’s company, Mitchell Counseling Services of New Bedford, also pleaded guilty to the charges.
“This defendant defrauded thousands of taxpayer dollars and took away critical health care coverage that is meant for some of our most vulnerable patients,” AG Coakley said. “This case makes clear that those who take advantage of these state programs will be held criminally responsible for their actions.”
After the pleas were entered, Superior Court Judge Richard Moses sentenced Benson to nine months in the House of Correction for larceny charges involving the state Medicaid program (MassHealth). Benson was also sentenced to two years in the House of Correction, suspended for a period of three years, for larceny charges involving Medicare. He was sentenced to 10 years of probation on all of the remaining charges.
Judge Moses also ordered that Benson pay restitution to MassHealth in the amount of $83,661, and to Medicare in the amount of $81,594.
Benson is a licensed independent clinical social worker in Massachusetts and is the sole manager of Mitchell Counseling Services which provides psychotherapy services for Medicaid and Medicare eligible patients as a QMB-only (Qualified Medicare Beneficiary) provider.
AG Coakley’s Medicaid Fraud Division began an investigation into Benson and his practice following a referral from the Executive Office of Health and Human Services after he was found to be the top QMB provider.
The AG’s extensive investigation revealed that Benson routinely billed for treatment that exceeded services provided in connection with seven patients. Benson billed as though his patients were in need of acute care multiple times each week, when Benson’s patients were provided either minimal, or no therapy at all. Regarding one patient, Benson submitted 497 claims to MassHealth for services that were not rendered.
A Bristol County Grand Jury returned indictments against Benson and Mitchell Counseling Center in September 2011. After three additional indictments were returned against both defendants, they were arraigned in November 2011.
The case was handled by Assistant Attorney General George Zachos and was investigated by Investigators Nate Downing, Joseph Shea and Ronald Velez, of the AG’s Medicaid Fraud Division, with assistance from Amber Foley of the AG’s Victim/Witness Services Division. Massachusetts State Police assigned to the Attorney General’s Office, and Special Agents from the Boston Office of the United States Department of Health and Human Services Office of the Inspector General also assisted in this case.