Counselor billed Medicaid for fictitious office visits
WILMINGTON, DE – Pamela Davis, 51, of Bear, a self-employed Licensed Clinical Social Worker operating PD Counseling Services out of several locations in New Castle County, was arrested July 8, 2015, for health care fraud, theft of more than $1,500, and falsifying business records.
Davis contracted with Delaware Medicaid and Medical Assistance and Delaware Physicians Care, Inc. to provide social work services to Delaware Medicaid recipients. As part of their normal course of business, Delaware Physicians Care, Inc. sent out verification letters to validate services rendered and accurate billing practices. In 2013, Delaware Physicians Care, Inc. received responses from several of Davis’ clients, advising they had not seen Pamela Davis for services rendered or paid on the dates in question.
Special investigators from the Delaware Department of Justice’s Medicaid Fraud Control Unit conducted interviews of Davis’ clients and discovered that from approximately January 2013 through May 2015, Davis routinely billed, and was paid by Delaware Physicians Care, Inc. for services that appear to have never been rendered. A search warrant of Davis’ business in June 2015 yielded logbooks containing alleged fraudulent patient visit information. Investigators allege that Pamela Davis billed Delaware Physicians Care, Inc. for 160 visits that never occurred and in return, fraudulently received over $11,500 in Medicaid funds for services not rendered.
Pamela Davis was arraigned at New Castle County Police Department and released on $22,000 unsecured bail.
In all cases, defendants are presumed innocent until and unless proven guilty.