Birmingham Psychologist Charged With Defrauding State Medicaid

BIRMINGHAM, AL — A Birmingham psychologist has been charged with defrauding the Alabama Medicaid Agency of more than $1 million. Sharon D. Waltz, 50, has agreed to plead guilty to the charge and pay restitution in the amount of $1.5 million.

An Alabama Media Group report said Waltz filed false claims for counseling servicesthat were not provided. Waltz operated Capstone Medical Resources in a number of locations around the state, with its primary officer in Birmingham.

A statement by Northern District of Alabama U.S. Attorney Jay Town said the costs of Waltz's crime are more than monetary. "The greed of this defendant deprived mental health care to many at-risk young people in Alabama, with the focus on profit rather than the efficacy of care," Town said. "The costs are not just monetary but have social and health impacts on the entire Northern District. This prosecution, and this investigation, demonstrates what is possible when federal and state law enforcement agencies work together."

"This defendant was entrusted to provide essential mental health care for young people who were at risk, and to provide these services through an agency with scarce resources for vulnerable Alabamians who are truly in need," Alabama Attorney General Steve Marshall said. "Her actions demonstrate a callous abuse of this trust and a fraud of staggering proportions against the Alabama Medicaid Agency and the taxpayers of our state. Thankfully, the vigilance of this agency served to protect public funds from further misuse and she has been held to account and punished for her crimes."

The Program Integrity Division of the Alabama Medicaid Agency launched an investigation after an audit showed that Waltz’s billings to the Medicaid Agency had increased from $99,000 in 2015 to more than $2.2 million in 2017. The findings of that audit were turned over to the Attorney General’s Medicaid Fraud Control Unit after Waltz submitted falsified records during the audit.

Another investigation was conducted by the Medicaid Fraud Control Unit and the Office of Investigations of the U.S. Department of Health and Human Services Office of Inspector General, which determined that the majority of claims submitted by Capstone from 2016 through 2018 were fraudulent.

Assistant U.S. Attorney J.B. Ward and Assistant Attorney General Bruce Lieberman, working as a Special Assistant U.S. Attorney, are prosecuting the case.