Attorney General Thurbert E. Baker announced today that agents from the state’s Health Care Fraud Control Unit had arrested Andrew Winston Felix for Medicaid Fraud. Following a presentation by the Attorney General’s Fraud Unit to the Fayette County Grand Jury, the grand jury returned a felony indictment against Felix for Medicaid Fraud yesterday. An arrest warrant was subsequently served this morning on Felix at his current offices in East Point, Georgia. After the investigation began and Felix was cut off from receiving additional Medicaid funds, Felix moved his offices from Fayette County to East Point.
Felix operated under the company name, Center for Educational Technology, and enrolled his company in the state Medicaid program as a provider of Intensive Family Intervention through the Community Mental Health Board. After his enrollment, Felix improperly recruited patients, hired employees who were not qualified mental health professionals, and billed for activities ranging from shopping to eating out a restaurants with his clients as therapeutic activities. Felix also billed for several patients for time spent with them “at school,” when in fact the school they attended was closed for the Christmas holidays during the time that Felix alleged to have accompanied them to school.
In addition, the Medicaid program requires that patients receiving service under the Intensive Family Intervention Program must have the service ordered by a physician or other licensed individual. Many of Felix’s patients either had no authorization in their file, had an authorization signed by an unlicensed individual, or had an authorization signed seven to eight months after CET begin billing for services. Felix is charged with fraudulently billing the state Medicaid program for $177,673.80 during the time period between October 2003 and November 2004.
In announcing the indictment, Attorney General Baker stated that “fraudulent providers like this were one of the main reasons that costs in the Medicaid program continued to rise, and today’s arrest would go a long way in deterring future fraudulent activity.” Baker also praised the work of the Department of Community Health in investigating the case, pointing out that their prompt investigative work saved the state “literally hundreds of thousands of dollars.” Attorney General Baker pledged “a continuation of the close cooperation between the Attorney General’s Office and the Department of Community Health to ensure that fraud, corruption and waste are swiftly removed from the state Medicaid program.
Baker singled out the work of the investigator for DCH, Danielle Funk, for her “stellar” handling of the fraud investigation. The case against Felix will be prosecuted by Assistant Attorney General Nancy Allstrom. Felix faces imprisonment of one to ten years and a fine up to $10,000.00, plus restitution, if convicted.