Silver State Times

Las Vegas, NV – On June 29, Attorney General Aaron D. Ford announced that Joy Behavioral Health, LLC (“Joy”) and its owner Edward Gamboa was sentenced in a Medicaid fraud case involving billing for services that were not provided to Medicaid recipients.

Joy was sentenced for a gross misdemeanor offense of Intentional Failure to Maintain Adequate Records by District Court Judge Eric Johnson. As part of the plea deal, Edward Gamboa, the sole owner of Joy, was previously sentenced for a misdemeanor offense of Acting Without Lawful Authority. Judge Johnson sentenced Joy and placed it on probation for two (2) years. As part of the sentence, Joy was also ordered to pay $110,000 in restitution. The fraud occurred between February 202 and July 2022.

“Our office will continue to take action against those who abuse the privilege of receiving taxpayer funds that are supposed to help Medicaid recipients.” said AG Ford. “My office will always endeavor to bring to justice health care providers engaged in such fraudulent billing practices.”

The investigation began after the MFCU received information which alleged that Joy was fraudulently billing Nevada Medicaid for recipient services that were never provided. The investigation revealed that Gamboa, through Joy, submitted fraudulent claims to Medicaid asserting that Rehabilitative Mental Health (RMH) services were provided to recipients when in fact they were not. The lack of services and the fraudulent claims were substantiated by the alleged provider of the services. Further, Joy failed to maintain the required documentation supporting such purported services.

The MFCU investigates and prosecutes financial fraud by those providing healthcare services or goods to Medicaid patients. The MFCU also investigates and prosecutes instances of elder abuse or neglect. The Nevada MFCU receives 75% of its funding from the U.S. Department of Health and Human Services under a grant award. The remaining 25% is funded by the State of Nevada, MFCU. Persons convicted of Medicaid fraud may also be administratively excluded from future Medicaid and Medicare participation. Anyone wishing to report suspicions regarding any of these concerns may contact the MFCU at 702-486-3420 or 775-684-1100.

The case was prosecuted by Andrew Schulke, Chief Deputy Attorney General.

Review the criminal complaint.

File a complaint with the Office of the Nevada Attorney General.

Original source can be found here