By Daniel Jones, editor
Roderick Davis Sr., Roderick Davis Jr., and Athena Mitchell have been arrested on multiple charges associated with alleged Medicaid fraud committed while they were employed by the ARC of Sabine (SARC).
Arrest warrants obtained by The Sabine Index state that Roderick Davis Sr. was charged with one count of felony Medicaid fraud and one count of felony exploitation of the infirmed. Roderick Davis Jr. has been charged with three counts of felony Medicaid Fraud and one count of felony criminal conspiracy. Athena Mitchell is charged with two counts of felony Medicaid fraud and one count of criminal conspiracy.
The Medicaid Program
The Louisiana Department of Health (LDH) is authorized to enter into contracts called “provider agreements” with entities who provide medical or medically related services. Following the execution of such provider agreements, such entities are certified as eligible Medicaid providers. Through the agreement mechanism, the providers are reimbursed by the Louisiana Department of Health for the services rendered to the Medicaid recipients. Reimbursement is made to a provider in accordance with the rates that are established by LDH.
The claims submitted on part of a provider discloses the recipient identification number and name of the Medicaid recipient receiving the services, address of the Medicaid recipient, and description of service provided, amount billed for each service, and date of service. These claims are presented and submitted to providers to DXC Technology, the technological “middleman” for Louisiana’s Medicaid system. That system receives and process Medicaid billing at its office in East Baton Rouge and remits payment to the providers.
Medicaid Fraud Scheme
On February 5, the Medicaid Fraud Control Unit opened an investigation involving SARC employee Roderick Davis Sr., based on allegations that Davis Sr. used SARC and recipients’ finances to purchase appliances for his personal use and personal rental properties. In addition, they alleged that he fraudulently billed Medicaid for services not provided and received payment from SARC for services that never occurred.
SARC is a Medicaid funded facility that provides job opportunities in addition to educational and work training to disadvantaged citizens through an adult day habitation program, residential living services for certain citizens in six separate community homes, and personal care services to Medicaid recipients in independent living environments.
Roderick Davis Sr.
Investigators interviewed several employees of SARC, which revealed that Davis Sr. had purchased multiple appliances with SARC funds. He would later reimburse SARC for the same appliances with funds from the recipients’ accounts. An invoice was obtained from SARC, which revealed a purchase in the amount of $479.99 was made from Hancock Furniture for a white Crosley Electric Range Stove for Group Home #5. Employees obtained a current picture of the stove in said group home which did not match the description or serial number of the newer stove purchased. Another invoice made note of a refrigerator purchased on February 14 for $579.99 from a local furniture store that was not located in the group home.
One SARC employee, identified as a mobile crew supervisor, was interviewed on May 2 and advised that he was instructed by Davis Sr. to pick up a refrigerator and deliver it to an address on Esso Street in Many, which is a rental property of Davis Sr.
Agents obtained a receipt from SARC which stated that Davis Sr. used a SARC Walmart credit card in December 2018 to purchase a television for a community home and two television and one sound bar for clients who live in the apartments. He was interviewed on March 27 and question as to the location of the purchases and advised the televisions were at his personal residents and had not given the televisions to the clients yet. Contact was later made at his personal residence and observed two of the three televisions in question. He would not give the location of the largest of the three television sets.
Davis Sr. was interviewed on March 27 and questioned about a refrigerator that was purchased with SARC funds. He signed a purchase request approval on February 14 for the appliance and admitted that it was purchased with SARC funds and picked up by a named employee, who was instructed to deliver the appliance to his Esso Street rental property in Many. Davis Sr. later went by the property and installed it. Davis Sr. stated that the employee didn’t question him as to why it was delivered to a personal rental property.
He stated that he had previously purchased with his own finances two refrigerators from Sears for his rental properties and installed one of those purchased with personal funds at a community home instead of the one purchased with SARC funds, because according to Davis Sr. it was a better refrigerator, and he did not want to put such a nice refrigerator in his rental property.
He was questioned as to why he approved a purchase request for an oven on July 26, 2018, and had it delivered to his personal rental property on Esso St. and had it delivered to his personal rental property. Davis Sr. later told the special agents they could be located at said rental property.
Other evidence has shown that Davis Sr. took advantage of disabled clients by using their personal funds to purchase appliances and electronics for his rental properties and had them work for his own benefit.
Athena Mitchell
The investigation discovered that Davis Sr.’s daughter, Athena N. Mitchell allegedly worked as a direct service worker, or DSW, for SARC during the same time she was enrolled in college.
Evidence gathered regarding her employment with SARC during the time she was in college states that she provided services to a Medicaid recipient at a residential address and enrolled as a student in the nursing program at Northwestern State University and performing her nursing clinicals in Shreveport. There were 24 miles between the residence of the client and NSU.
Records were received by the investigators from the Louisiana Service Reporting System (LaSRS), SARC, and Northwestern State University related to the times/dates of work and attendance of Mitchell. An analytical report of the records was conducted, and revealed Mitchell was logged in using the verification software as proof she was providing services to the client, when she was attending her scheduled classes at Northwestern State University. Mitchell and Davis Sr. submitted the required paperwork to SARC to be paid by Medicaid for services that were not rendered. She was paid by SARC via checks which were endorsed by Mitchell and Davis Sr. and were deposited into Mitchell’s bank account. It was confirmed that Mitchell, in collaboration with her father, failed to provide services to the client, and knowingly falsified the required documentation that formed the basis of the claim.
On March 27, special agents conducted an onsite visit at the SARC office in Many and noted there were no employment files for Mitchell and minimal service logs located regarding the services Mitchell allegedly provided to the client. During an interview with Davis Sr., he advised he was not worried about the missing papers, because the recipient is his mother and DSW is his daughter. Davis Sr. also confirmed that Athena Mitchell is enrolled in the nursing program at Northwestern State university and living in Shreveport while performing her clinical studies. He also advised that Mitchell probably doesn’t provide all of the services that Medicaid was billed for, due to her living in Shreveport and attending school. He presumed the client had been checking her in and out of work using the Electronic Visit Verification system and in turn caused fraudulent billing to occur, so she would be paid for services not rendered. Davis Sr., as supervisor of Mitchell, printed the EVV logo from the LaSRS system and submitted them for payment knowing the services had not been performed as reflected in the logs.
Davis Sr. also reaffirmed during the interview that he picks up his daughter’s paycheck and deposits it in his bank account and when he asks for funds, he transfers money into her account.
Roderick Davis Jr.
Investigators complete a background check on Roderick R. Davis Jr., the son of Roderick Davis Sr., which revealed he was employed as a supervisor in one of SARC’s group homes in Many while also employed as a truck driver in Cisco, Texas. Employment records were requested from his employer and SARC, which included the times he was allegedly working with SARC.
The records were compared by an analyst employed by the Louisiana Department of Justice, Office of Attorney General Jeff Landry. The results reflected that Davis Jr. submitted timecards for SARC for December 27, 2017, through May 28, 2018, when he was actually in Texas working for the trucking company. Time cards for Davis Jr submitted to SARC totaled 343.2 fraudulent hours, which were paid by SARC to Davis Jr. from Medicaid money. He was working and being paid these same dates and times by the trucking company in Texas. The group homes are funded by Medicaid based on the severity of a patient’s needs and amount of patients who are residing in the home. The combined portion Medicaid reimbursed SARC for Davis Jr.’s employment at the home was calculated by the biller which amounted to $11.81 per hour. The amount calculated with the overlapping hours of his employment totaled $4,053.19.
When Davis Sr. was interviewed by special agents on March 27, he stated that his son worked for SARC for approximately eight years, but resigned his employment in December, 2018. During his employment he worked in the community homes preparing meals and cleaning. Davis Jr. began working with the trucking company while employed at SARC, but his times did not overlap, and he drove the trucks on his days off from SARC. Davis Sr. sometimes picked up his son’s paychecks from SARC and deposited the checks in Davis Jr.’s bank account. The father advised the schedules are set at the community homes and employees know their schedules. The employees are required to clock in and out of work using a time clock, and Davis Sr. rarely had to edit a timecard. Community home managers bring the time cards to him, who in turn gives them to a named SARC employee for payroll. These checks were received by Davis Jr. or Davis Sr, endorsed, and deposited into Davis Jr.’s banking account.
The warrant states that Davis Sr.’s actions in conjunction with his son Davis Jr. and daughter, Athena Mitchell, resulted in the submission of false claims by SARC and the Louisiana Medicaid program. It was apparent from the evidence collected that Davis Sr. and his children conspired to submit claims for services not rendered in order to obtain greater compensation than legally entitled to receive.