VERDICT: Jury Convicts City of Philadelphia Employee of Billing Medicaid Providers for Work He Did Not Perform

April 27, 2023 | Topic: Criminal

HARRISBURG—Attorney General Michelle Henry today announced that Cornelius Edwards was convicted of fraudulently billing multiple Pennsylvania Medical Assistance (Medicaid) providers for services that he never provided.

A Philadelphia County jury returned guilty verdicts on Monday for Medicaid Fraud, Theft by Deception, and Tampering with Public Records.

Edwards, 45, of Philadelphia, will be sentenced on June 26, 2023 by the Honorable Nicholas Kamau.

The Office of Attorney General presented evidence at trial that Edwards repeatedly submitted inaccurate timesheets while working as a mental health professional for children with behavioral and mental health challenges. During this same time period, Edwards was also employed by the City of Philadelphia’s Parks and Recreation Department.

“Maintaining mental health and wellness continues to be a challenge for young people. Instead of being part of the solution, Edwards abused this trust and defrauded the system for his own gain,” said Attorney General Henry. “This conduct was very obviously fraudulent and downright theft, and my office will not allow any individual to unlawfully abuse programs designed to help residents of the Commonwealth.”

Between April 2014 and April 2018, Edwards was working for multiple Community Behavioral Health (CBH) providers as a Licensed Behavioral Specialist consultant, a Mobile Therapist and a Lead Clinician. While working for the CBH providers, Edwards repeatedly submitted timesheets that falsely reported the services that he was providing in order to receive additional compensation.

In his timesheets, Edwards reported providing multiple overlapping services, including: individual services for more than one child at a time; individual services to children at their homes when he was providing school-based services; and therapy services for times while he was working for The City of Philadelphia. A parent testified that Edwards was only ever at her house for 30-60 minutes, but he consistently reported on his timesheets that he had been there for one and a half to two hours.

The jury found that Edwards received money from Medical Assistance for services that he could not have provided. In doing so, Edwards deprived children of necessary mental health services and falsified their medical records.

This case was prosecuted by Senior Deputy Attorney General Elizabeth Madigan and Supervisory Special Agent James Conn.

The Pennsylvania Medicaid Fraud Control Unit receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award totaling $9,781,180 for Federal fiscal year (FY) 2023. The remaining 25 percent, totaling $3,260,392 for FY 2023, is funded by Pennsylvania.

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