Heidi Robertson, 35, was employed as the primary insurance biller at a Birmingham-area psychology clinic that billed the Medicaid Agency for counseling services that were never provided. Robertson was sentenced to 18 months in prison and ordered to pay $850,000 in restitution after she pleaded guilty earlier this year to one count of conspiracy to commit healthcare fraud by filing false claims to the Alabama Medicaid Agency for individual and group counseling services for at-risk youth while she was employed at Capstone Medical Resources LLC. The owner of the facility, former Birmingham psychologist Sharon D. Waltz, pleaded guilty in 2019 to defrauding Medicaid of at least $1.5 million. An investigation was initiated by the Program Integrity Division of the Alabama Medicaid Agency after an audit showed that billings submitted by Capstone for counseling services had increased from $99,000 in 2015 to more than $2 million in 2017. The Program Integrity Division referred its findings to the Attorney General’s Medicaid Fraud Control Unit after Waltz submitted falsified records during the Program Integrity Audit. A subsequent investigation was conducted by the Medicaid Fraud Control Unit and the US Department of Health and Human Services Office of Inspector General. This investigation determined that most claims submitted by Capstone from 2016 to 2018 were fraudulent.
