CT behavioral health worker convicted of health care fraud

A Waterbury behavioral health provider who was previously convicted of Medicaid-related crimes and barred from working with the program has now been convicted of health care fraud involving Medicaid and ordered to pay $25,000 compensation, according to the files.

Elijah Caldwell, 43, appeared in Hartford court Thursday and was sentenced to three years in prison, suspended, followed by three years in prison for providing behavioral health services to Medicaid clients and billed Medicaid for these services when he was not authorized to do so. working with Medicaid because of a prior criminal conviction, according to the Division of Criminal Justice.

The sentence means Caldwell will not serve prison time but will have to pay restitution and was ordered not to act as a Medicaid provider, officials said.

Caldwell was previously barred from participating in Medicare, Medicaid and all federal health care programs for 10 years, according to the DCJ. Court records show he was convicted of third-degree forgery and fourth-degree theft in 2018.

An investigation by the Chief State's Attorney's Office's Medicaid Fraud Control Unit found that between October 2019 and January 2020, Caldwell provided behavioral health services at Primal Mental and Physical Health in Oakville and billed Medicaid, according to the DCJ.

Officials said Caldwell submitted his claims to the Department of Human Services “knowing they contained false, incomplete, misleading and misleading information.”

Caldwell pleaded nolo pretend to the health care fraud charge.

Suspected public health care fraud or abuse can be reported to the Medicaid Fraud Control Unit of the Chief State Attorney's Office at 860-258-5986.