A Silver Spring, MD woman was sentenced for defrauding the state’s Medicaid program of over $1 million by billing for speech language therapy services that were never provided to juvenile recipients.
Per the Maryland Attorney General’s Office: “Attorney General Anthony G. Brown today announced the guilty plea and sentencing of Elia Torres, 44, of Silver Spring, Maryland, on charges of Medicaid Fraud. On September 30, 2024, Ms. Torres pleaded guilty to defrauding the Maryland Medicaid program of more than $1,000,000 by billing for speech language therapy for juvenile Medicaid recipients that were never provided. Medicaid is a joint federal-state program that provides healthcare benefits to low-income individuals.
Judge Mary Beth McCormick of the Circuit Court for Montgomery County sentenced Elia Torres to five years’ incarceration with all but 18 months suspended, to be served on home detention, a three-year term of probation, and a $10,000 suspended fine. The defendant is liable for restitution in the amount of $1,019,719.71, with $225,000 paid at the time of sentencing. The defendant is also prohibited from providing healthcare services that are either partially or wholly funded by state or federal governments.
“Medical professionals rely on the Maryland Medicaid program to help some of the most vulnerable people in our state. When providers fraudulently bill for Medicaid, they undermine public trust in this important program and deprive low-income Marylanders who need healthcare,” said Attorney General Brown. “Our office will protect Maryland Medicaid funding so more people can get the quality care they need for healthy, fulfilling lives.”
From January 1, 2019, through January 31, 2024, Ms. Torres operated a speech language therapy company named Diversity Talks, LLC. The patient population for these services was almost exclusively children, many of whom have parents that do not speak English as their primary language. Ms. Torres has been a licensed Speech-Language Pathologist in Maryland since 2005.
During the investigation, the state obtained progress notes from Ms. Torres for approximately 40 Medicaid recipients. Every recipient was billed for receiving speech language therapy seven days a week, except on certain holidays, for two to five years continuously, and even purportedly receiving services on weekends. The recipients ranged in age from under two years old to young teenagers. Most of these children did not need speech-language therapy. There were other aspects of the progress notes that indicated that Ms. Torres was billing for speech-language services that were not rendered. For example, Maryland Medicaid paid her $517,033.13 for services to infants.
The Attorney General’s Medicaid Fraud and Vulnerable Victims Unit conducted interviews with the parents of more than 30 different patients billed by Diversity Talks. All parents reported that their child did not receive therapy seven days a week, nor on weekends. Notably, two families that had moved to New York and North Carolina, respectively, reported that Diversity Talks continued billing for appointments for more than a year after they had moved.
In making today’s announcement, Attorney General Brown thanked the Medicaid Fraud and Vulnerable Victims Unit and Assistant Attorneys General James M.C. McHale and Kelly Casper, as well as Senior Fraud Analyst Paul Kidd, Senior Fraud Analyst Shannon Beatty, Fraud Analyst Laura Webber, Fraud Analyst Dreama Smith, Fraud Analyst Kevin Clements, and Senior Investigative Auditor Todd Sheffer for their work on the case. Attorney General Brown also thanked the Prince George’s County Police Department, Narcotics Enforcement Division Gang Unit, for their assistance in the investigation.
The Maryland Office of the Attorney General, Medicaid Fraud and Vulnerable Victims Unit receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award totaling $6,057,128 for Federal fiscal year (FY) 2024. The remaining 25 percent, totaling $2,019,042 for FY 2024, is funded by the State of Maryland.”