Braking Point defendants ‘wreaked havoc’ on health care system, special agent says

News

The case of the rise and fall of a large drug and alcohol facility in Austintown is coming to a close

YOUNGSTOWN, Ohio (WYTV) – The case of the rise and fall of a large drug and alcohol recovery facility in Austintown is coming to a close as six people involved in a fraud case pleaded guilty to various crimes in the scheme.

Six people pleaded guilty to crimes related to a health care fraud conspiracy in which millions of dollars for drug and alcohol recovery services were billed to Medicaid but were not provided or medically necessary.

Ryan P. Sheridan, 39, of Leetonia; Jennifer M. Sheridan, 41, of Austintown; Kortney L. Gherardi, 30, of Girard; Lisa M. Pertee, 51, of Sunbury; Dr. Thomas Bailey, 45, of Poland, and Arthur H. Smith, 55, of Austintown pleaded guilty to crimes related to a health care fraud conspiracy in which millions of dollars for drug and alcohol recovery services were billed to Medicaid but were not provided or medically necessary.

The defendants are expected to be sentenced in January 2020.

All six pleaded guilty to crimes related to their work at Braking Point Recovery Center, which operated drug and alcohol rehabilitation facilities in Austintown and Whitehall, Ohio.

According to court documents, Sheridan owned Braking Point Recovery Center and owned and operated numerous other businesses, including Braking Point Health and Fitness and Braking Point Recovery Housing.

As part of his ownership, prosecutors say Sheridan and the other defendants submitted bills to Medicaid for drug and alcohol services that were coded to reflect a service more costly than was actually provided and billings for patients whose records did not contain a diagnosis by a doctor.

Bailey was found guilty of prescribing the drug Suboxone even though he did not have the authority to do so, prosecutors said.

In court filings, prosecutors said the Sheridans, Gherardi, Pertee, Bailey and Smith developed a standard protocol of distributing the same amount of Suboxone to every patient seeking drug treatment immediately upon entering Braking Point’s detox program without being evaluated by a properly licensed physician to determine the medical necessity for the use of Suboxone.

The Sheridans, Gherardi and Bailey are also accused of using Smith’s DEA data waiver license to dispense more than 3,000 doses of Suboxone in 2017 alone without Smith having seen the patients.

Smith was seen as Braking Point’s medical director but only went to the facility approximately twice a month, according to court documents.

“These defendants stole tens of millions of dollars from taxpayers through fraudulent billing and other crimes,” U.S. Attorney Justin Herdman said. “They used the drug epidemic plaguing Ohio as a way to line their pockets and profited off the suffering of others.”

The scheme lasted about two years between January 2015 and October 2017 when Braking Point submitted about 134,744 claims to Medicaid for more than $48.5 million.

The claims caused Medicaid to pay Braking Point more than $31 million. Medicaid suspended payments on October 18, 2017.

“Ryan Sheridan and his co-defendants wreaked havoc on the integrity of our health care system for their own personal gain,” said Bryant Jackson, Special Agent in Charge, IRS Criminal Investigation, Cincinnati Field Office. “Health care fraud affects every American and today’s announcement illustrates that the IRS and our law enforcement partners are steadfast in our commitment to detecting and dismantling health care fraud schemes and holding perpetrators of these crimes accountable.”

Copyright 2021 Nexstar Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

Trending on WYTV.com