Las Vegas, NV – Today, Nevada Attorney General Aaron D. Ford announced that Lavell James Worthy, Jr., 34, of Las Vegas, was sentenced in a Medicaid fraud case involving the failure to maintain adequate records. The false claims were submitted to Nevada Medicaid between March 1 and December 23, 2017.
Judge Michael Cherry sentenced Worthy to 364 days in jail, suspended, and placed Worthy on probation. As a part of his sentence, Worthy was ordered to pay $100,000 in restitution. Individuals or businesses convicted of Medicaid fraud may also be administratively excluded from future Medicaid and Medicare participation.
“Worthy intentionally misused the Medicaid reimbursement system for his own gain,” said AG Ford. “My office will not allow Medicaid providers to cheat Nevada out of resources reserved for vulnerable individuals. Providers, be on notice that my office will continue to aggressively prosecute these crimes to protect those in need of these services.”
The investigation of this case began after the Attorney General’s Medicaid Fraud Control Unit (MFCU) received information that Worthy, the owner of Spirit of David Behavioral Health, LLC, was using his business to submit false claims for services that were never actually provided to Medicaid patients. The investigation revealed that Worthy failed to maintain medical records necessary to substantiate claims billed to Nevada Medicaid. For the minimal documentation that was preserved, many of the notes indicated Medicaid recipients no longer wanted to receive services – however, Worthy, through the operation of Spirit of David, continued to submit claims to Medicaid for payment for medical services that were allegedly provided to his imaginary “customers.”
The MFCU investigates and prosecutes financial fraud by those providing healthcare services or goods to Medicaid patients. The MFCU also investigates and prosecutes instances of elder abuse or neglect. The Nevada MFCU receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award. The remaining 25 percent is funded by the State of Nevada, MFCU. Anyone wishing to report suspected fraud regarding any of these concerns may contact the MFCU at 702-486- 3420 or 775-684-1100.
This case was investigated by the Attorney General’s Medicaid Fraud Control Unit and prosecuted by Senior Deputy Attorney General Behnaz Salimian Molina.
To view the criminal information of Lavell James Worthy, Jr., click here. To file a complaint with the Office of the Nevada Attorney General, click here.