Princeton Social Worker Accused Of $1.7M In Medicaid Fraud

PRINCETON, NJ — A mental health provider in Princeton improperly billed and was paid more than $1.7 million in Medicaid funds, according to an audit report released by the New Jersey Office of the State Comptroller (OSC).

The OSC is seeking full repayment from Sokkyun Yi, a Princeton-based licensed social worker who provides intensive in-community mental health services in New Jersey.

As part of its oversight of the New Jersey Medicaid program, OSC’s Medicaid Fraud Division conducted an audit of claims submitted by and paid to Yi from Sept. 21, 2016 through March 2, 2020, for services provided by Yi and others with whom he had contracts.

Yi does business under the name Family First Counseling Services.

The OSC’s audit found that around 54 percent of the 963 claims reviewed contained inaccuracies.

Yi submitted inaccurate and inadequate documentation and of 963 claims reviewed, 311 had inaccurate documentation. In some cases, forms also were missing pages and/or required signatures, the audit showed.

The OSC found 18 claims in which Yi billed, and was paid, for a higher-level, higher-paying service than was actually provided.

Officials also found improper billing for travel time or for overlapping services. In some cases, Yi billed for services provided by one professional at the same time for different Medicaid beneficiaries.

The OSC said YI failed to ensure behavioral assistants met the minimum standards set by New Jersey Medicaid.

Yi, for instance, was unable to provide OSC with copies of high school diplomas or equivalents for six of the 15 behavioral assistants in the audit sample.

Yi also allowed four behavioral assistants to provide services without having received the appropriate training and certification. One behavioral assistant was permitted to work without the requisite proof of successfully completing a criminal background check.

The audit report found a “troubling pattern of Yi failing to meet core regulatory requirements” which not only led to him receiving overpayments but put many at risk.

“Providers who receive New Jersey Medicaid dollars have a legal obligation to comply with these requirements. OSC will continue to audit providers to ensure that Medicaid beneficiaries receive the services that New Jersey pays for and that taxpayer dollars are not improperly spent,” Joshua Lichtblau, Director of OSC’s Medicaid Fraud Division, said in a statement.

OSC aims to recover $1,795,277 from Yi, and has recommended that he implement several corrective actions to address the deficiencies identified in their audit report.

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