Birmingham Psychology Clinic Employee Pleads Guilty To Fraud

BIRMINGHAM, AL — A former employee of a Birmingham area psychology clinic who officials say defrauded the Alabama Medicaid Agency of at least $1.5 million by billing for counseling services that were never provided pleaded guilty Wednesday. Heidi Robertson, 35, pleaded guilty to one count of conspiracy to commit health care fraud for her role in filing false claims to the Alabama Medicaid Agency.

Robertson was employed as the primary insurance billing official for Capstone Medical Resources, LLC. The owner of the facility, former Birmingham psychologist Sharon D. Waltz, pleaded guilty in 2019 to defrauding Medicaid.

Court reports show an investigation was initiated by the Program Integrity Division of the Alabama Medicaid Agency after an audit showed that billings submitted by Capstone for counseling services had increased from $99,000 in 2015 to more than $2 million in 2017. The Program Integrity Division referred its findings to the Attorney General’s Medicaid Fraud Control Unit after Waltz submitted falsified records during the Program Integrity Audit.

A subsequent 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. This investigation determined that the majority of claims submitted by Capstone during 2016 through 2018 were fraudulent.

Robertson’s role in the scheme included submitting claims using the Medicaid identifications of the children of friends and family members for counseling services that never took place, according to a report from the U.S. Attorney's Office. Waltz paid Robertson a 10 percent commission for all claims paid by Medicaid, officials said. Robertson was employed by Waltz from 2016 through late 2017.

“The defendant’s actions demonstrated reckless disregard for at-risk youth,” U.S. Attorney Prim F. Escalona said. “The U.S. Attorney’s Office will continue to work with our law enforcement partners to protect the members of our community that are the most vulnerable, our children.”