An Arlington man has been sentenced to federal prison for his role in a health care fraud scheme in the Eastern District of Texas, announced U.S. Attorney Brit Featherston.
Jason Neil Hughes, 48, pleaded guilty Sep. 10, 2021 to healthcare fraud and was sentenced to 14 months in federal prison Tuesday by U.S. District Judge Robert W. Schroeder, III. Hughes was also ordered to pay restitution in the amount of $416,124.68 to private health insurers.
According to information presented in court, Hughes was the owner and operator of ChangePoint Counseling Service, a mental health clinic in Forney. He founded ChangePoint in 2013 and sold it in 2019. Between 2015 and 2019, Hughes carried out a scheme to defraud private health care insurers through the submission of false and fraudulent claims.
Hughes and others incorrectly billed private insurance claims using a Texarkana doctor’s National Provider Identifier for counseling services that the doctor did not provide. Although ChangePoint’s counselors had their own NPI numbers that could be used for billing counseling services, ChangePoint – at Hughes’s direction – used the doctor’s NPI to submit claims because the use of the doctor’s NPI resulted in higher payments from insurers. This billing practice resulted in ChangePoint receiving an average of 100% to 120% additional money paid per service from health insurers.
This case was investigated by the Federal Bureau of Investigation’s Tyler Field Office and prosecuted by Assistant U.S. Attorney Robert Austin Wells.