Tennessee Attorney General Jonathan Skrmetti filed a lawsuit against the former owners of Dynamic Therapy Center, LLC, a defunct therapy clinic in Mount Juliet, for defrauding Tennessee’s Medicaid program, TennCare.
The lawsuit filed in Wilson County Circuit Court alleges that Karyn Kurth and Michelle Hill, who owned and operated Dynamic Therapy Center from 2020 to 2023, knowingly submitted false claims to TennCare.
The defendants are accused of billing TennCare for individual physical therapy, occupational therapy, and speech therapy sessions while actually providing group therapy to children in sessions they called “camps.” Since TennCare reimburses individual therapy sessions at higher rates than group sessions, this fraudulent scheme resulted in a substantial number of overpayments to Dynamic Therapy Center.
“Fraudsters who abuse our trust to rip off TennCare are stealing from Tennessee taxpayers and will be held accountable,” said Attorney General Skrmetti. “As always, our Office is grateful to fight for Tennessee taxpayers and TennCare patients alongside our partners at the TBI.”
The state is requesting recovery of more than $300,000 in fraudulent payments, treble damages as allowed under state law, civil penalties of $14,308 to $28,619 per violation, and additional remedies the court deems appropriate under the Tennessee Medicaid False Claims Act.
The joint investigation by the TBI and Office of the Attorney General’s Civil Medicaid Fraud Division began with a referral from TennCare’s Office of Program Integrity.
“We’re committed to doing our part to protect the tax dollars meant to support our most vulnerable,” said TBI Director David Rausch. “This case is another great example of how partnership among law enforcement agencies can work to hold accountable those abusing the TennCare system.”
Pr25 47 Complaint by scott.mcclallen
In fiscal year 2023-2024, Tennessee identified about $29.5 million in fraud to TennCare and other federal health care programs at a cost of $2.9 million to the state of Tennessee and resulted in the indictment of 36 individuals and the conviction of 39 others, according to an annual report.
Annual Report 2023 2024 by scott.mcclallen
The Medicaid Fraud Control Division mostly investigates fraud from licensed practitioners, individual providers, medical services, facilities, and abuse, neglect, and financial exploitation of another.
About 75% of the division is federally funded through a grant with a mandate to investigate and prosecute Medicaid provider fraud, the abuse and neglect of residents in health care facilities and board and care facilities, and the abuse and neglect of Medicaid beneficiaries.
As of June 30, 2024, the MFCD has active cases on 43 of the 82 different types of providers. From July 1, 2023 through June 30, 2024, the group opened a total of 108 fraud and abuse cases and closed 93.
There were a total of 36 individuals indicted in MFCD during the past state fiscal year and 39 individuals convicted in both provider fraud and patient abuse, neglect and financial exploitation cases.