PORTLAND, Maine — A Gorham man was arrested Tuesday on a federal health care fraud charge connected to his mental health and substance abuse practices in Portland and Windham.
Paulo D. Braga, 66, is accused of billing MaineCare for providing services to 40 patients on dates he was traveling outside of the United States, according to a complaint filed Tuesday in U.S. District Court.
He allegedly received $5,202 for the unprovided services, according to an investigation by a special agent with the U.S. Department of Health and Human Services’ Office of the Inspector General.
The federal prosecutor maintained that the fraudulent activity occurred from about April 3, 2011, and April 30, 2012.
Braga closed his practice in 2013 and allowed his licenses to expire at the end of that year.
A native of Brazil who was naturalized as a U.S. citizen in May 1981, Braga was licensed as a clinical professional counselor by the Maine State Board of Counseling and a certified clinical supervisor by the Maine State Board of Alcohol and Drug Counselors.
As such, he was reimbursed for some of his services by MaineCare, a health insurance program for disabled and low-income people administered by the Maine Department of Health and Human Services.
An investigation was launched into Braga’s business practices after a staffer with the state Department of Health and Human Services’ Division of Program Security became suspicious that Braga was billing MaineCare for services on days when he did not see a patient and was falsifying records to document counseling sessions that did not occur.
Among other things, the state investigator’s investigation found Braga’s client files were inadequate and noted that there was a significant amount of shredded paper all over the floor of his Windham office.
The investigator found some discrepancies, among them that progress notes for patients did not address any significant issues and that some also contained multiple progress notes for the same date of service, which violates MaineCare regulations.
The investigator also found that Braga was billing mental health codes for clients who were supposed to be seeing him for substance abuse treatment required as part of the state’s Driver Education and Evaluation Program.
Braga’s treatment plans were not unique to a client’s issues and client signature pages seemed to have been photocopies by Braga and used for multiple entries, the investigator found.
If convicted, Braga faces up to 10 years in prison and a fine of up to $250,000 as well as up to three years of supervised release upon completion of his prison term, according to court documents.
Also, Braga kept Driver Education and Evaluation Program clients for 14 to 18 months as opposed to the norm of three to four months, the federal complaint stated.