Case Management

Former non-profit owner to serve 12 years for fraud scheme

Compliance Monitor, May 4, 2011

Shirlene Reese Boone of Murfreesboro, NC, will serve 12 years in prison followed by three years’ supervised release, and pay $4.6 million in restitution for her guilty plea of conspiracy to commit healthcare fraud, according to a Department of Justice (DOJ) press release.

Boone was the principal owner, manager, and registered agent for Metropolitan Counseling Services, Inc. (MCS), a registered non-profit North Carolina corporation that provides community support services and HIV case management.

According to the DOJ, between 1997 and May 2010, Boone submitted claims for reimbursement to the Medicaid program for services that never occurred. According to the DOJ, Boone instructed employees to fabricate medical records to support 37.5 hours per week of community support or HIV services or they would not be paid. In several instances, Boone directed MCS employees to fabricate progress notes for community support services allegedly performed by other MCS employees or former employees. The employees were not sufficiently qualified or licensed to lawfully perform the billed services.

During the investigation, the government searched Boone’s offices in Murfreesboro and seized multiple boxes of fabricated medical records and other evidence. At the time of the search, Boone’s employees admitted to falsifying medical records.

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