Owners of Chicago youth counseling center indicted in $4M Medicaid fraud scheme

File folders labeled "insurance," "fraud," "claims," and "under investigation"
The owners of a Chicago youth counseling center have been charged with fraud. (Getty Images/Olivier Le Moal)

The co-owners of a Chicago youth counseling center have been indicted on charges that they defrauded Illinois' Medicaid program out of $4 million.

Summer Matheson, 41, and Terrance Ewing, 57—both of Dyer, Indiana—are charged with submitting fraudulent bills to Medicaid for mental health services that were not provided through the Laynie Foundation.

The organization is described as a Medicaid-certified community mental health agency where intensive outpatient mental health and behavioral health treatment is provided to underserved and at-risk youth and their families specializing in the treatment of sexual, emotional and physical abuse and suicidal situational care needs. 

Case Study

Across-the-Board Impact of an OB-GYN Hospitalist Program

A Denver facility saw across-the-board improvements in patient satisfaction, maternal quality metrics, decreased subsidy and increased service volume, thanks to the rollout of the first OB-GYN hospitalist program in the state.

Matheson and Ewing were charged alongside foundation employee Richard Grundy, 34, of Chicago, in the multimillion-dollar scheme, the Department of Justice (DOJ) announced.

Federal officials charged Matheson and Ewing with six counts of healthcare fraud; Matheson is also charged with one count of obstruction of justice. Grundy was charged with five counts of healthcare fraud.

RELATED: Some states struggle to vet providers to prevent Medicaid fraud, OIG finds

In addition to billing for healthcare services, the trio is accused of using the foundation to seek Medicaid payments for services that are not reimbursed such as internal case reviews, staff training, record keeping and clinical supervision, according to the indictment.

The indictment also charges that Matheson attempted to cover up the fraudulent billing by asking staff to backdate and falsify patient records to make it appear as though a physician had approved the services.

The charges follow DOJ's and the Illinois attorney general's entries into a whistleblower case filed against the foundation.

Suggested Articles

CMS Administrator Seema Verma put accreditation organizations on notice over their surveys and consulting arms.

Blue Shield of California is teaming up with Accolade to offer self-insured employers a personalized way to connect with members about their benefits.

In a survey, 23% of people admitted that they have lied to their doctors. Here are eight tips for doctors to encourage patients to tell the truth.