Today's Paper River Valley Democrat-Gazette Newsletters Public Notices Obits Distribution Locations Digital FAQ Razorback Sports Today's Photos Crime Puzzles

Billing director at care provider arrested in Arkansas Medicaid fraud case

by Eric Besson | August 22, 2018 at 4:30 a.m.

A former Preferred Family Healthcare billing director arrested on two felony counts of Medicaid fraud received pay from an Arkansas lobbying firm and a "separate" mental health care provider, according to court documents.

Helen Balding, 47, arrested Monday, was described in an investigator's affidavit as an "accomplice" to former company executive Robin Raveendran, who is accused of directing employees to improperly bill Medicaid.

Raveendran was arrested June 29 on two felony counts of Medicaid fraud. He told Preferred Family employees by email to file forged claims totaling $2.3 million between January 2015 and October 2017, authorities said.

Balding is accused of carrying out that order despite knowing it was improper.

Balding's last day of employment at Preferred Family was March 20, said company spokesman Reginald McElhannon, who did not say whether she resigned or was fired.

Balding was hired in November 2009 by Alternative Opportunities, which merged with Preferred Family in May 2015, McElhannon said. Preferred Family's name was retained, but Alternative Opportunities executives were installed in key positions, including chief executive officer and chief officers over finance, clinical operations, and operations.

Balding received $59,000 from one of lobbyist Rusty Cranford's firms and $85,000 from a separate, unnamed "mental health Medicaid provider" between January 2015 and December 2017, according to an affidavit signed by Rhonda Swindle, who investigates Medicaid fraud in the attorney general's office.

Balding also earned "at least $194,000" in that two-year span from Preferred Family, the affidavit says.

Cranford and Raveendran "arranged [Balding's] positions with these other entities," according to the document, which was filed in Independence County Circuit Court on Aug. 16. It does not address whether her non-Preferred Family compensation was related to the fraud accusations.

Cranford earlier this year pleaded guilty to bribing Arkansas officials as a wide-ranging federal public-corruption investigation continues in Arkansas and Missouri. Cranford also worked as Preferred Family's director of Arkansas operations and arranged kickbacks to lawmakers who directed money to the nonprofit, according to court documents.

Raveendran joined Preferred Family in 2014 as its director of program integrity, also serving as executive vice president and analyst. Before joining the behavioral-health provider, Raveendran worked as chief program administrator for the state Department of Human Services program integrity unit.

"One of Cranford's closest associates was Robin Raveendran," the affidavit says. "The full scope of their relationship is the subject of an ongoing investigation involving multiple companies."

Four former state lawmakers have pleaded guilty to or have been convicted of bribery, conspiracy and embezzlement charges stemming from two federal investigations, one in Arkansas and one in Missouri. Court pleadings have largely focused on Preferred Family, until this year one of Arkansas' largest providers of Medicaid-eligible outpatient mental-health services.

The state's Medicaid fraud investigation began in 2016 after the FBI contacted Attorney General Leslie Rutledge's office, documents say.

The attorney general's office filed the charges against both Raveendran and Balding in Independence County.

Though the FBI's initial tip fizzled because too much time had elapsed since the alleged crime, Rutledge's office said it learned that "several" providers under Medicaid fraud investigation -- mostly in the field of mental health -- were "all connected to a small group" of lobbyists and consultants, Swindle's affidavit says. So the attorney general's Medicaid fraud unit opened "one large investigation."

The Arkansas Department of Human Services discontinued Medicaid reimbursement to Preferred Family after Raveendran's arrest. The nonprofit, which operates in five states, has since announced that it is in negotiations to sell its Arkansas mental-health and substance-abuse facilities to TrueNorth, a sister company of a Russellville firm.

Multiple former Preferred Family executives were forced out as the investigation unfolded. Court documents implicated former members of the nonprofit's executive team in crimes involving Cranford and former lawmakers, but those executives have not been charged.

In Balding's case, a probable-cause affidavit says she fraudulently billed the free insurance program for children and low-income Arkansans despite knowing that state regulations require providers to verify that other insurers won't cover the costs.

Specifically, Preferred Family billed Medicaid when it could have billed Medicare, federally funded insurance for the elderly. Medicaid's reimbursement rates are higher than those allowed under Medicare, according to court documents.

Balding, a former Fayetteville resident, surrendered Monday at the Independence County jail and left after posting bond, said Cody Franks, a jailer. Rutledge's office announced the arrest Tuesday.

"The alleged actions of these former [Alternative Opportunities] leaders and employees do not reflect the integrity and values Preferred Family Healthcare represents, and which our current employees exhibit daily," McElhannon said in a printed statement.

McElhannon, citing multiple ongoing investigations, declined to answer specific questions about when company leadership became aware of the alleged Medicaid fraud scheme and when it ended.

Swindle's affidavit said current Preferred Family leadership has "fully cooperated throughout this investigation," including granting access to internal emails, notes and data.

A month ago, Balding moved to New Braunfels, Texas, about 30 miles northeast of San Antonio, and stopped communicating with investigators, the affidavit says. She did not respond to a message left on her cellphone Tuesday afternoon.


More headlines

Metro on 08/22/2018

Print Headline: Billing director at care provider arrested in Arkansas Medicaid fraud case


Sponsor Content