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Woman Charged for Alleged Medical Assistance 'Scheme' in Phoenixville

Shannon Roe, 32, of Malvern, faces several felony charges brought by the Pennsylvania Office of the Attorney General.

 

The state Office of the Attorney General is pursuing charges against a therapist who allegedly billed for services she didn’t deliver through a Phoenixville community service organization.

Shannon Roe, 32, of Malvern, is free on $10,000 unsecured bail after being arraigned on several felony charges and 54 misdemeanor forgery charges stemming from incidents dating back to 2008.

A whistleblower alerted Devereux Community Services, Roe’s employer at the time, to the possible fraud. Devereux, located at 1041 W. Bridge St., then conducted an internal investigation and later passed those findings on to the Pennsylvania Office of the Attorney General, which brought the charges against Roe.

According to a criminal complaint filed by a special agent of the Attorney General’s office, Roe was employed by Devereux as a family-based mental health therapist. The organization contracts with the Department of Public Welfare (DPW) to provide services to people with developmental disabilities and mental health issues who are receiving medical assistance.

In her role, Roe was charged with providing intensive therapy to children and adolescents at risk of being hospitalized for psychiatric disorders or placement in programs away from home. She had to fill out progress notes and timesheets, known as encounter forms, that would show the child’s name, the date and the amount of time Roe provided treatment, as well as signatures of the parent or legal guardian and Roe herself.

“The completed progress notes and encounter forms were then submitted by Roe to Devereux, who paid Roe based on the amount of hours reportedly worked by her during that time period,” the criminal complaint states.

The information also served as a basis for billing the medical assistance program through an Exton-based behavioral health organization. The forms Roe was submitting, however, were allegedly inaccurate, so DPW was paying for services that had not been rendered.

“Devereux determined that Roe submitted encounter forms for services she did not provide, as well as encounter forms with forged daily signatures,” the criminal complaint states.

On April 7, 2011, the special agent spoke to two parents whose children had been Roe’s clients. The agent asked a mother to review forms Roe submitted, and the woman told the agent she didn’t sign the forms or give permission for Roe to sign on her behalf. The parent told the agent Roe hadn’t seen her child for the number of times listed, either, and that on several occasions where it said therapy was rendered, the child was actually still in school.

A second mother told the agent she did sign the forms, but that they had been blank at the time she signed them.

“[The woman] stated that when Roe came by herself, it was usually for 10 or 15 minutes to ask for signatures on the encounter forms, never the two to two and a half hours of therapy that Roe consistently reported to Devereux,” the complaint states.

The criminal complaint goes on to state that Roe “engaged in unlawful conduct which defrauded the Medical Assistance program.

“The scheme consisted of knowingly and intentionally submitting encounter forms with fraudulent times indicating that [family-based mental health] services were provided when in fact they could not have been provided because she was not with the children during most of these dates and times,” the complaint states.

Evidence attached shows encounter forms from February 2009 through May 2009 in one case and from December 2008 to May 2009 in another for a total of $11,700 billed for 97.5 hours of therapy. Each session listed was at least an hour and a half, with one as high as five and a half hours.

Roe faces felony charges for false or fraudulent medical assistance claims, submitting claims for services not rendered to patients, submitting claims for services not rendered by a provider, three different felony counts of theft by deception and one felony count of receiving stolen property in addition to the 54 misdemeanor forgery charges.

Roe was arraigned on Jan. 26 and a preliminary hearing is scheduled for Feb. 9 in district court in Phoenixville. 

Related Topics: Crime in Phoenixville

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