Anti-Medicaid Fraud Crusader & Political Candidate Accused Of Medicaid Fraud
A Greenville state Senate candidate who has made an issue of the state's overpayment of mental health claims is himself on the hook for $4.2 million in Medicaid overcharges for services provided by his family's company.
Frankie Bordeaux and his wife, Hattie Faye Hardy Bordeaux, signed a settlement with the state in February that included a two-year repayment plan for money improperly collected by Cambridge Behavioral Health Services in Greenville. The first monthly payment, $241,296, was due this month.
An investigation of Cambridge by the state Medicaid office found hundreds of cases of incomplete patient records, "several instances of potential fraud," duplicate or "canned" notes, and unqualified staff delivering care, according to the settlement.
Of 476 records reviewed, the office found 428 cases in which patients were served at unauthorized sites, 366 instances in which the staff was not qualified to provide the service offered, and hundreds of other discrepancies with their records. The review found problems with nearly 95 percent of the company's claims.
Groups under scrutiny
For the last several years, the state has been cracking down on providers of a mental health service called community support.
Companies came under scrutiny when government auditors found they were treating people who did not need help and were billing for work they didn't do. Legislators last year decided to phase out most of that program.
The $4.2 million deal with Cambridge is the second-highest settlement with a mental health company in the last four years, according to the Medicaid office.
The case was sent to the Medicaid Investigations Unit in the state attorney general's office. An investigation is under way.
Bordeaux said he is not an example of the mess he has pledged to clean up.
"I am not part of the problem," Bordeaux said. "While my name is associated, tied to it, it has nothing to do with me running for this seat."
Bordeaux, who incorporated the company that became Cambridge with his wife, is not an owner, his lawyer said. Bordeaux said he is now the administrative director, in charge of human resources and the business office.
Fighting NC Corruption
Bordeaux, a Democrat, is challenging incumbent Sen. Clark Jenkins in a primary in the district covering Edgecombe, Martin and Pitt counties.
He has made fighting government corruption a cornerstone of his campaign, even criticizing the state Department of Health and Human Services for its overpayments to companies such as his that offer community mental health services.
"Like most citizens, I am growing weary of news headlines documenting public corruption and scandal in our state government," says a statement on his campaign Web site.
"Graft, corruption and scandal are not acceptable and politicians and bureaucrats who personally benefit from their service - need to be prosecuted and punished," the statement continues. "Furthermore, we must do more to hold bureaucrats and government officials accountable for their actions."
Jenkins, who is seeking a fifth term, has always faced a Democratic primary opponent.
Bordeaux has tried to paint Jenkins, a longtime friend of Senate leader Marc Basnight and a former state Department of Transportation member, as out of touch with the district.
The wrong location
Bordeaux said most of Cambridge's problems resulted from the company's serving clients in unauthorized offices.
Cambridge was serving patients from offices in Rocky Mount before the company discovered it needed clearance from the local mental health office to operate from those locations, Bordeaux said.
Local mental health offices must endorse providers and their locations.
Each location gets a separate billing number, so that local offices can track which providers are working in their regions.
In October 2008, a local mental health office in Rocky Mount reviewed Cambridge's records and directed the company to stop taking new patients from its area. But Cambridge continued to do so through December 2009, according to a letter from the local office.
The legal settlement says that Cambridge presented bills for the patients as though they were being treated from the Greenville office, rather than from Rocky Mount.
Not the owner
James Jorgensen, a Raleigh lawyer representing Cambridge, said situation was the result of poor communication between the company and the local mental health office, which is called the Beacon Center. "I think Cambridge misunderstood what the Beacon Center requested of them," he said.
Jorgensen wanted to make it clear that Frankie Bordeaux does not own the company.
Only Bordeaux's wife is listed on the most recent business incorporation papers. She holds the title of manager. Bordeaux signed earlier versions of the business filings and was an incorporator, with his wife, of Cambridge Behavioral Health's precursor, Child & Adolescent Counseling Services Inc.
Cambridge denied in the settlement that it committed abuse or fraud.
"If we had litigated, we could have shown a lot of things that could have been rebutted," Jorgensen said.
Brad Crone, head of the Raleigh campaign firm Bordeaux hired, said Jenkins tried use the settlement to push Bordeaux out of the race.
Jenkins said he never used the settlement to pressure Bordeaux not to run.
"I do not intend to get in the mud with that," Jenkins said. "I did not do it."
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Sources: McClatchy Newspapers, NC Senate.org, Youtube, Google Maps
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