Rehab Facility Sued For Medicaid Fraud

Attorney General Patrick Morrisey announced his office is seeking more than $236,000 from a Wood County drug rehabilitation facility for alleged fraudulent Medicaid claims at a press conference Wednesday morning at the Wood County Courthouse.

However, the facility, Clean & Clear Advantage, LLC said in a statement provided to West Virginia Public Broadcasting Wednesday afternoon, that the company is also a victim of fraud.

According to the statement, in 2021, a man named Clifford Marlowe forged his credentials and documentation to Clean & Clear Advantage, LLC, and the company argues, took advantage of the turbulent COVID-19 pandemic to get a job as a therapist.

Marlowe did not have the required degree and was not a licensed master-level therapist. He also did not hold a healthcare license from the state.

“From the moment this deception was uncovered, Clean & Clear has fully cooperated with the investigation conducted by the West Virginia Attorney General’s Office,” the statement reads. “Clean & Clear is a victim of Mr. Marlowe’s egregious fraud, who targeted the facility at a time of great difficulty for us and the entire country, and we are working diligently to support state authorities in holding him accountable.”

Marlowe was indicted in September and charged with two felony counts of Medicaid fraud and fraudulent schemes.

Morrisey alleges claims for 52 patients, totaling nearly $79,000, were filed by Marlowe. He said his office was tipped off and his Medicaid Fraud Control Unit investigation found fraudulent claims submitted to the state’s Medicaid program from May 2021 through January 2022.

“We believe that this individual was not qualified to render the services he did under the Medicaid law, and then, because the company did not take the steps to return the money that the company also is civilly liable to the Medicaid program for damages,” Morrisey said.

Morrisey acknowledged that Clean & Clear attempted to pay the $79,000.

“There was an effort made by the company to simply send a check in, in order to pay for the underlying amount that was alleged to have been improperly billed,” Morrisey said. “But that’s not how this works. If you allegedly violate the law, you’re not only subject to the simple money that you may have obtained improperly from overpayments. You’re likely to be subject to penalties as well. So that’s part of this process.”

Morrisey said his office is seeking three times the amount claimed as a signal to those who might try to take advantage of opioid settlement money flowing into the state.

“Anytime there’s a disaster and people are donating charitably, scammers come out to play,” Morrisey said. “But we want to send a message that that’s not going to be tolerated here in West Virginia.”

Morrisey is running in the 2024 General Election as the Republican nominee for Governor of West Virginia.

Appalachia Health News is a project of West Virginia Public Broadcasting with support from Marshall Health.