Former State Employee Sentenced in Health Care Fraud Case

A former Connecticut state employee has been sentenced to two years in prison for her role in what federal authorities call a health care fraud scheme.

Toshirea Jackson, 50, of Bridgeport, was sentenced on Thursday.

According to John Durham, United States Attorney for the District of Connecticut, as of January 2012, Jackson and Juliet Jacob operated Transitional Development and Training and It Takes A Promise, two businesses located at 360 Fairfield Ave. in Bridgeport that provided social and psychotherapy services and they used those businesses to bill Medicaid for psychotherapy services that were never provided.

Federal officials said Jackson and Jacob used the Medicaid provider numbers of two licensed health care providers employed by the Connecticut Department of Mental Health and Addiction Services who had not provided or supervised any of the psychotherapy services that Jackson and Jacob billed to Medicaid.

Federal officials said the two providers didn’t authorize Jackson or Jacob to obtain provider numbers for them at TDAT or ITAP and were not aware that TDAT or ITAP were billing Medicaid as if the providers had provided the psychotherapy services.

In March 2012, Nikkita Chesney, who was employed by a health care provider that provided substance abuse treatment that included a detoxification program in Bridgeport started to steal personal identification information, including Medicaid identification number, Social Security Numbers and dates of birth, from patients of her employer, federal officials said.

Jackson, Jacob, and Chesney then used the stolen identity information to bill Medicaid for psychotherapy services that the Medicaid clients had never received, federal officials said.

They said Jackson admitted that the scheme involved stealing the identity of more than 150 Medicaid clients and they had successfully billed Medicaid for around half of those clients.

Jackson also admitted that she and her co-conspirators billed Medicaid for services to other clients that were never provided to those clients, federal officials said.

Jackson pleaded guilty on Dec. 13 to one count of health care fraud and is scheduled to report to prison on July 12 to serve 24 months. She was be on supervised release for three years after serving the sentence. She has also been ordered to pay nearly $2.5 million in restitution.

Federal officials said Jacob pleaded guilty on Oct. 18 to one count of health care fraud.

On Oct. 23, Chesney pleaded guilty to one count of health care fraud and one count of aggravated identity theft. Both await sentencing.

Federal officials said five other people have been charged and convicted of health care fraud offenses due to this and related investigations.

People who suspect health care fraud are encouraged to report it by calling 1-800-HHS-TIPS.

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