Former CEO of St. Gabriel Health Clinic convicted of $1.8 million Medicaid fraud scheme
After a week-long trial, a federal jury convicted the former CEO of St. Gabriel Health Clinic Inc. for conducting a multi-year, multi-million-dollar scheme to defraud the Louisiana Medicaid Program.
According to court documents and evidence presented at trial, Victor Clark Kirk of Baton Rouge, was the CEO of St. Gabriel Health Clinic Inc., a Louisiana non-profit corporation that provided health care services to Medicaid recipients and others. The clinic was a federally qualified health center (FQHC) that contracted with the Iberville Parish School Board to provide medical services within the school district.
As a FQHC, St. Gabriel could provide primary care services to students as well as services related to the diagnosis and treatment of mental illnesses – provided that such services were medically necessary – among other requirements.
Evidence at trial showed that St. Gabriel practitioners, at Kirk’s direction, provided character development and other educational programs to entire classrooms of students during regular class periods. Kirk then caused the fraudulent billing of these programs to Medicaid as group psychotherapy. To facilitate the fraudulent scheme, Kirk directed that the clinic's practitioners falsely diagnose students with mental health disorders. From 2011 through 2015, Kirk caused more than $1.8 million in fraudulent claims for purported group psychotherapy services.
Throughout the week, the federal jury heard testimony from former practitioners and employees of St. Gabriel Health Clinic, as well as former employees of East Iberville Elementary and High School and MSA East, two Iberville Parish schools where St. Gabriel operated satellite clinics. The jury also heard testimony from parents whose children received false Axis-I mental health diagnoses in their medical records as part of the fraudulent scheme.
“The Medicaid program was established to provide healthcare to those most in need," said U.S. Attorney Ronald Gathe, Jr. "This verdict demonstrates that the Department of Justice, along with our federal and state partners, will marshal the necessary resources to protect the vulnerable who rely on that program as well as the taxpayers who fund it.”
"I am proud of my office’s work with our law enforcement partners to help achieve this conviction,” Attorney General Jeff Landry said. “The mental health of our State’s most vulnerable, especially in our youth, should not be jeopardized or compromised by fraudsters. I would also like to applaud our Special Agent Joseph Springer for his exceptional work that helped secure this conviction.”
“Any time greed replaces medical necessity as the primary factor in behavioral health services, our most vulnerable citizens are imperiled,” said Acting Special Agent in Charge Jeffrey Richards of the HHS Office of Inspector General's Dallas Regional Office. “Our HHS OIG agents will continue to work closely with our law enforcement partners to investigate providers who will stop at nothing to loot the Medicaid program.”
“Today’s guilty verdict sends a clear message that individuals like Mr. Victor Clark Kirk who engage in healthcare fraud will not go undetected and will be held accountable. The FBI is determined to identify, investigate, and bring to justice those who are committing healthcare crimes to enrich themselves at the expense of others,” said FBI Special Agent in Charge Douglas A. Williams, Jr. “We thank our partners at the United States Attorney’s Office for the Middle District of Louisiana, the Department of Justice’s Criminal Division, Fraud Section, the Medicaid Fraud Control Unit, and the U.S. Department of Health and Human Services – Office of Inspector General for their strong partnership and unrelenting pursuit of justice.”
Kirk was convicted of conspiracy to commit health care fraud and five counts of health care fraud. He is scheduled to be sentenced on January 12, 2023, and faces a maximum penalty of 10 years in prison per count. A federal district court judge will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors.
U.S. Attorney Ronald C. Gathe, Jr. for the Middle District of Louisiana; Assistant Attorney General Kenneth A. Polite, Jr. of the Justice Department’s Criminal Division; Special Agent in Charge Douglas A. Williams, Jr. of the FBI; Director Jodi Edmonds LeJeune of the Louisiana Medicaid Fraud Control Unit (MFCU); and Acting Special Agent in Charge Jason Meadows of the Department of Health and Human Services, Office of the Inspector General (HHS-OIG) made the announcement.
The FBI, MFCU, and HHS-OIG investigated the case, which was brought as part of the Gulf Coast Strike Force, supervised by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Middle District of Louisiana.
Assistant U.S. Attorney Kristen L. Craig for the Middle District of Louisiana and Assistant Chief Justin M. Woodard and Trial Attorney Kelly Z. Walters of the Criminal Division’s Fraud Section prosecuted the case.
Kirk was initially charged as part of a National Health Care Fraud Enforcement Action announced in September 2019, when the U.S. Attorney’s Office announced charges against six (6) individuals for health care fraud in Baton Rouge. The Gulf Coast Strike Force is part of a joint initiative between the Department of Justice and HHS to focus their efforts to prevent and deter fraud and enforce current anti-fraud laws around the country.
Since its inception in March 2007, the Health Care Fraud Strike Force, which maintains 16 strike forces operating in 27 districts, has charged nearly 4,000 defendants who have collectively billed the Medicare program for more than $14 billion. In addition, the HHS Centers for Medicare & Medicaid Services, working in conjunction with HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.