Norway therapist gets probation for health care fraud




  • In US
  • 2022-01-07 23:31:00Z
  • By Sun Journal, Lewiston, Maine

Jan. 7-PORTLAND - A Norway woman who defrauded MaineCare while working as a social worker was sentenced to probation Thursday by a judge who acknowledged her "extraordinary" cooperation with federal authorities in exposing a wide-ranging health care fraud conspiracy in central Maine.

Heather Borst, 40, was tearful as she sat in her attorney's office appearing by videoconference for the hearing in U.S. District Court.

In addition to a year of probation, Chief Judge Jon D. Levy ordered Borst to pay roughly $471,000 in restitution.

She pleaded guilty two years ago to felony health care fraud. She faced up to 10 years in jail on the charge, but prosecutors recommended only probation, noting her willingness to cooperate, which included surveillance recording and testifying before a grand jury and at trial against other defendants.

Prosecutors said Borst had, for more than two years, defrauded Maine's Medicaid program in the delivery of or payment for health care services.

Borst, who earned a master's degree in social work, provided mental health counseling as a licensed clinical social worker.

Starting in January 2015, Borst started submitting claims to the Maine Department of Health and Human Services for treating patients that were billed with interpreter services.

Investigators reviewed billing by her office through June 2017 and found that she had submitted nearly all of the claims for 2.5-hour visits when, in fact, each visit actually lasted roughly 15 minutes, according to court documents.

On one of the days she submitted claims, she purported to have rendered 24 hours worth of services.

In 2017, investigators observed her office to track the number of clients and duration of their visits. After monitoring activity where the client visits were brief or no clients appeared, they reviewed claims she submitted to MaineCare and discovered she had billed for visits that lasted 2.5 hours, according to court documents.

During an interview with investigating agents in 2017, after initially denying wrongdoing, she admitted to having submitted false claims for more than two years for her services as well as interpreter services.

Rick Berne, Borst's attorney, said Thursday that Borst had suffered from low self-esteem and had overcome an eating disorder and substance abuse earlier in life.

She was later diagnosed with bipolar disorder and depression and found it difficult to stand up to others who were more forceful, including Abdirashid Ahmed, who operated an interpreting service in Lewiston.

The fraud had started with Borst stepping in for another therapist who was on maternity leave. But even after Borst learned of the illegal nature of the practice, she continued with it.

Assistant U.S. Attorney Daniel Perry said Borst likely would have continued with her criminal conduct had she not been caught.

Berne said his client has lost her profession and has already begun repaying MaineCare - $2,100 to date - by working two jobs.

After taking a break so she could compose herself, Borst read a statement, saying she had taken full responsibility for her actions and was remorseful and ashamed for her treatment of family and individuals she harmed during her criminal conduct.

"I will spend the rest of my life trying to make amends," she said.

Levy said Borst showed "complete disregard" for her professional responsibility and had used the people she was supposed to treat as "tools in the commission of this crime."

He continued: "It has to be said this is really outrageous conduct."

But he said the level of cooperation with federal agents as well as remorse Borst has demonstrated since her fraud was exposed had been "extraordinary."

Two Lewiston men were sentenced last year for their respective roles in carrying out a conspiracy that included sending Somali patients to MaineCare providers to receive counseling services as long as they were paid as interpreters.

Perry said successful prosecution of those cases had relied on Borst's cooperation.

Levy told Borst she had gone "down a rabbit hole," but has emerged to live a "humble existence we all applaud."

She has been out of jail on bail since her 2019 plea without any problems, Levy said, adding he considered those two years as proof that Borst has successfully rehabilitated herself.

"I encourage you to understand that your life, in the end, will not be defined by this crime," Levy told her. "Use your remorse as a catalyst for positive things."

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