Woman Charged In Alleged $9 Million Fraud Involving Behavior Therapy
COLUMBIA, S.C. — Federal authorities are seeking to recover $9 million that they say a South Carolina woman stole in a wide-ranging scheme involving false medical bills for treating children with autism.
Susan A. Butler, the “founder” of the Early Autism Project, is charged with overbilling Tricare and Medicaid, two federal health insurers, and making false claims about patient services. Money the insurers paid for patient care instead went for administrative costs, according to a federal grand jury indictment made public this week.
Butler “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,” according to the indictment.
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With seven South Carolina clinics, the Early Autism Project is the state’s largest care center for children with autism. Its website says Butler founded the company in 1995.
Today, it treats hundreds of children and “offers the highest quality of intensive, research-based behavioral treatment for children and young adults between 20 months and 21 years with autism spectrum and related disorders,” according to its website.
That internet site says government health insurers — Tricare, for active-duty military members, and Medicaid, for low-income Americans and those with disabilities — will “pay for some or all” autism treatments.
Greenville lawyer Beattie Ashmore, an attorney for Butler, could not be reached immediately for comment. Butler’s place of residence is unclear. Various sources give it as Lexington, Sumter or Charleston.
ChanceLight, an autism care firm with nearly 19,000 clients at more than 150 locations in 20-plus states., bought the Early Autism Project’s South Carolina clinics in 2013.
In a statement, ChanceLight said the billing practices questioned by the government were in place when it acquired the Early Autism Project. It added Butler no longer works for the company, declining to say when she stopped being an employee.
Senior vice president Sarah Vega said ChanceLight “cooperated fully with the government.” The company has taken steps, including hiring outside experts to evaluate its billing practices, to ensure it is complying with all regulations, Vega added.
In August, the U.S. Attorney’s office in Columbia announced the Early Autism Project had paid $8.8 million to settle a civil case under the False Claims Act, alleging it had submitted false claims to Tricare and the South Carolina Medicaid program for children with autism.
That settlement resolved allegations the Early Autism Project had submitted numerous false bills, padding the hours that therapists were billing Tricare and Medicaid for treatments. The Early Autism Project and its parent company admitted no fault in the settlement.
Records in that case are sealed and not available to the public.
However, in the August press release, the U.S. attorney’s office in Columbia said the case began when a whistleblower, former Early Autism Project employee Olivia Zeigler, brought the allegations to the government’s attention.
Under the False Claims Act, a whistleblower can file a lawsuit on behalf of the government. If the government gets involved and recovers money, the whistleblower gets part of any settlement. Zeigler was paid $435,000, the U.S. attorney’s office said.
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