Louisiana clinician gets prison for role in $1.8M Medicaid fraud scheme

A clinician for a Louisiana-based federally qualified health center was given a 14-month sentence for her role in a $1.8 million Medicare fraud scheme, The Advocate reported Nov. 20. 

Marilyn Antwine, 54, was a staff member at St. Gabriel (La.) Health Clinic, which contracted with the Iberville Parish School Board to provide medical services within the school district for medical services, according to the report. The health center could provide primary care services to students as well as services related to the diagnosis and treatment of mental illnesses. 

Ms. Antwine ran day-to-day operations at the clinic when CEO Victor Kirk was unavailable. Mr. Kirk was convicted in September of masterminding a scheme directing practitioners to falsely diagnose students with mental health disorders. From 2011 to 2015, the clinic fraudulently billed these programs to Medicaid as group psychotherapy, the report said. 

Federal prosecutors alleged that Ms. Antwine fired an employee who refused to alter the billing codes on invoices that Medicaid had denied, according to the report. 

Ms. Antwine will serve eight months in prison and six months in a transitional living facility, according to the report. She previously pleaded guilty to attempted conspiracy to commit healthcare fraud. 

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