The Early Autism Project (EAP) is a provider of health care services for children with autism in South Carolina. However, some of the staff involved in this company have been taking advantage of countless families and government health insurance companies. The fraud was brought to the government’s attention by a whistleblower, who happened to be a parent of a child with autism who used EAP’s services. She noticed that she was being billed for misrepresented hours of treatment that her child was not receiving.
The U.S. Attorney’s District of South Carolina believes “EAP allowed its therapists to regularly ‘pad’ the hours it billed for therapy services to the Tricare program and to South Carolina Medicaid, such that these programs regularly paid for therapy services that were not provided.” Employees also forged parent signatures on documents that stated their children had actually received the therapy that they were being billed for. The fraud scandal was widespread, affecting many vulnerable families, specifically children with autism who did not receive the therapy and treatment that they needed.
Two staff members, Ann Davis Eldridge, 57, and Angela Keith, 53, have been making false statements for supposed treatments through an inflation of bills to Medicaid and Tricare for behavioral therapy, a common therapy used to help those affected by autism. As Disabilityscoop states, a crime of this nature is considered felony fraud and charges carry a sentence up to four years in prison if the women were convicted. Given both Eldridge and Keith plead guilty to lesser charges of making false statements, which is a misdemeanor, they will spend six months and one year in prison, respectively.
Their sentences were significantly reduced since both women agreed to testify against Susan Butler, founder and former executive of EAP, who is fighting the charge. According to an article in The State, Butler was the main target, who “paid or caused to be paid kickbacks and bribes to clients by illegally offering free child care services for siblings,” and billed Medicaid and Tricare “at higher rates than allowable for the services rendered.”
U.S. Attorney DeWayne Pearson told the judge that “although she [Eldridge] made more money from the scheme than Keith — [she] was considered to have played a lesser role in the fraud.” When sentencing, Judge Gossett considered the testimonies of two mothers of children with autism who utilized the services and behavioral therapy provided by the Early Autism Project. Both mothers spoke very highly of Eldridge, expressing their appreciation for the hours she spent working with their children who have showed significant improvement.
Chancelight, a national autism-care firm, bought the Early Autism Project’s clinics in South Carolina in 2013. According to ABC, EAP and Chancelight repaid the government approximately $9 million for over-billing Medicaid and Tricare. A spokesman from Chancelight tells the Herald, “Immediately after learning of the investigation, we hired outside experts who helped evaluate and enhance billing practices.” Going forward, Chancelight and EAP must have procedures in place to ensure that children with ASD actually receive the support and treatment that they need and are entitled to.