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Former Healthcare CEO of Health Clinic in Louisiana Convicted of Medicaid Fraud Scheme Totaling $1.8 Million

On September 27, 2022, after a week-long trial, a federal jury in Louisiana convicted the former CEO of St. Gabriel Health Clinic Inc. for conducting a multi-year, multi-million-dollar scheme to defraud the Louisiana Medicaid Program.

Victor Clark Kirk of Baton Rouge, Louisiana, was the CEO of St. Gabriel Health Clinic Inc. (St. Gabriel), a Louisiana non-profit business that offered health care services to Medicaid patients and others, according to court documents and evidence presented at trial. St. Gabriel was a federally qualified health facility (FQHC) that worked with the Iberville Parish School Board to provide medical services to students. St. Gabriel, as a FQHC, could provide primary care services to students, as well as services related to the diagnosis and treatment of mental illnesses, if such treatments were medically necessary, among other conditions.

During regular class periods, St. Gabriel practitioners delivered character development and other educational activities to full classrooms of pupils, according to evidence presented at trial. Kirk then caused these programs to be fraudulently billed to Medicaid as group psychotherapy. Kirk directed St. Gabriel practitioners to falsely diagnose students with mental health issues in order to facilitate the fraudulent plan. Kirk was responsible for over $1.8 million in fraudulent claims for ostensibly group psychotherapy treatments from 2011 to 2015.

The federal jury heard testimony from former St. Gabriel practitioners and staff, as well as former employees of East Iberville Elementary & High School and MSA East, two Iberville Parish schools where St. Gabriel maintained satellite clinics, throughout the week. In addition, the jury heard testimony from parents whose children were given bogus Axis-I mental health diagnoses in their medical records as part of the fraudulent plan.

According to U.S. Attorney Ronald Gathe, Jr., “the Medicaid program was created to provide healthcare to those in greatest need.” This judgment illustrates that the Department of Justice, in collaboration with our federal and state partners, will mobilize the necessary resources to protect both the vulnerable who rely on the program and the taxpayers who fund it.”

“I am proud of my office’s work with our law enforcement partners to help achieve this conviction,” said Louisiana Attorney General Jeff Landry. “The mental health of our State’s most vulnerable, especially in our youth, should not be jeopardized or compromised by fraudsters. I would also like to applaud our Special Agent Joseph Springer for his exceptional work that helped secure this conviction.”

“Any time greed replaces medical necessity as the primary factor in behavioral health services, our most vulnerable citizens are imperiled,” said Acting Special Agent in Charge Jeffrey Richards of the HHS Office of Inspector General’s (OIG) Dallas Regional Office. “Our HHS OIG agents will continue to work closely with our law enforcement partners to investigate providers who will stop at nothing to loot the Medicaid program.”

“Today’s guilty verdict sends a clear message that individuals like Mr. Victor Clark Kirk who engage in healthcare fraud will not go undetected and will be held accountable. The FBI is determined to identify, investigate, and bring to justice those who are committing healthcare crimes to enrich themselves at the expense of others,” said FBI Special Agent in Charge Douglas A. Williams, Jr. “We thank our partners at the United States Attorney’s Office for the Middle District of Louisiana, the Department of Justice’s Criminal Division, Fraud Section, the Medicaid Fraud Control Unit, and the U.S. Department of Health and Human Services – Office of Inspector General for their strong partnership and unrelenting pursuit of justice.”

Kirk was found guilty on five charges of healthcare fraud and conspiracy to commit healthcare fraud. He is expected to be sentenced on January 12, 2023, and the maximum penalty for each count is ten years in jail. A federal district court judge will impose a sentence based on the United States Sentencing Guidelines and other statutory circumstances.

The announcement was made by U.S. Attorney Ronald C. Gathe, Jr. for the Middle District of Louisiana, Assistant Attorney General Kenneth A. Polite, Jr. of the Justice Department’s Criminal Division, FBI Special Agent in Charge Douglas A. Williams, Jr., Director Jodi Edmonds LeJeune of the Louisiana Medicaid Fraud Control Unit (MFCU), and Acting Special Agent in Charge Jason Meadows of the Department of Health and Human Services, Office of the Inspector General (HHS-OIG).

The case was investigated by the FBI, MFCU, and HHS-OIG as part of the Gulf Coast Strike Force, which was overseen by the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Middle District of Louisiana.

The case was prosecuted by Assistant U.S. Attorney Kristen L. Craig for the Middle District of Louisiana, as well as Assistant Chief Justin M. Woodard and Trial Attorney Kelly Z. Walters of the Criminal Division’s Fraud Section.

Kirk was initially accused as part of a National Health Care Fraud Enforcement Action initiated in September 2019, when the United States Attorney’s Office announced charges against six (6) individuals in Baton Rouge for health care fraud.

The Gulf Coast Strike Force is a combined endeavor of the Department of Justice and HHS to focus their efforts on preventing and deterring fraud and enforcing current anti-fraud statutes across the country. Since its establishment in March 2007, the Health Care Fraud Strike Force has prosecuted over 4,000 individuals who have collectively billed the Medicare program for more than $14 billion. Furthermore, the HHS Centers for Medicare and Medicaid Services, in collaboration with the HHS-OIG, are taking steps to strengthen accountability and reduce the presence of fraudulent providers.

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