Treatment facility operator accused of Medicare and Medicaid fraud, is considered a flight risk

Editor’s note: This story is published here courtesy of a content sharing agreement with the N.C. Health News.

By Rose Hoban

One of the dozens of health care facility owners caught in a federal Department of Justice sting announced Wednesday was supposedly defrauding patients in the western part of North Carolina.

Armando “Manny” Gonzales owned Health Care Solutions Network, a licensed mental health facility based in Hendersonville, and is named in court papers filed by the US Department of Justice as defrauding Medicare and Medicaid in Florida and North Carolina.

No one was answering the phone at Health Care Solutions Network, and the organization’s website had been taken down as of Thursday morning.

In court papers filed in the U.S. District Court office in Asheville Wednesday, Gonzales is accused by the US Department of Justice of bilking Medicare and Medicaid out of a total of $63 million over the course of six-and-a-half years.

According to the US DOJ, Gonzales fled South Florida in 2008 once he realized he was being investigated for Medicare fraud, came to North Carolina where he established the Hendersonville facility and was planning to open an operation in Johnson City, Tenn.

The papers accuse Gonzales of paying kickbacks to owners of assisted living facilities and nursing homes in exchange for referring Medicare beneficiaries for treatment at Health Care Solutions Network.

Penny Summey, a program administrator at the Department of Social Services in Henderson County, said the facility closed down several months ago, and clients are being served in other programs.

The facility was established as a not-for-profit in North Carolina and is still licensed with the state as a mental health day treatment provider as of April 2012.

“Up until they closed their doors, we thought they had provided very good service to the clients. The clients seemed to make advances in many ways while they were being served there,” Summey said.

But the word on the street was that things at Health Care Solutions was not so rosy.

“We have a mental health roundtable where professionals meet monthly,” said Susan Logan, psychiatric case manager at the Free Clinics of Henderson County. “When the facility first opened, we had one or two people from their public relations department come and give out slick brochures.”

Logan said one positive was that someone from the organization would go out and pick up clients in a van and bring them back to the facility – a plus in a place where public transit is scarce and clients scattered in small towns and down backroads. But local professionals quickly began to express doubts about the facility and its management.

“One of the doctors I knew who I respect and who said he’d work there in the beginning quit quickly,” Logan said. “He said it was a bad organization.”

According to the court documents, the facility was supposed to be offering an intensive mental health service called a Partial Hospitalization Program, used for people with severe mental health problems, such as schizophrenia or bipolar disease. People with dementia or other memory problems are not eligible to receive the service.

The court papers allege that Gonzales altered patients’ medical records to indicate they were eligible for the treatment. Patients with Alzheimers disease were sometimes bussed from their residences several counties away, traveling as much as an hour, to the facility on Old Naples Road in Hendersonville where they were shown old movies or did not receive any treatment at all.

An spokesman for the state Division of Health Service Regulation said the division inspected Health Care Solutions Network last June and found no deficiencies. Division records show no administrative actions against the facility.

Court papers said Gonzales, a Cuban national, is considered to be a flight risk and requested pre-trial detention.

Gonzales was convicted of cocaine trafficking in 1984, and sentenced to five-and-a-half years in prison on that offense. His current charges carry a potential maximum sentence of 145 years.

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