Two people, including a repeat offender, were recently convicted of felonies after defrauding the Maryland Medicaid program of $3.6 million.

According to the Maryland Attorney General’s Office, between November 2019 and September 2024, Parkville residents Robert E. Higgins and Tasha S. Saunders made a series of fraudulent claims on behalf of two behavioral health companies in Baltimore: Guiding Lives Inc. and Another Chance Supportive Services, Inc.

Embellished with forged signatures, fake patient records and the stolen identities of both healthcare providers and Medicaid recipients, the claims resulted in $3,672,958.66 of reimbursements for nonexistent services.

According to the state Department of Health, about 1.8 million Marylanders are enrolled in Medicaid. While the program’s funding has come primarily from the federal government, proposed budget cuts this year by the Republican-led Congress and White House could shift that burden toward state taxpayers.

Court records show Higgins and Saunders each pleaded guilty to two counts of defrauding a state health plan — a felony that carries a maximum sentence of five years in prison or a $100,000 fine — and are scheduled for sentencing later this year: Higgins on July 15 and Saunders on July 21.

“This outrageous conduct is an insult to the one in five Marylanders who rely on Medicaid for health coverage. These crimes harm our State’s neediest residents and the health providers who care for them,” Maryland Attorney General Anthony Brown said in a statement. “We will defend the funding of this critical program that allows people to live full, healthy lives.”

Assistant Attorney General James McHale said Tuesday that Saunders and Higgins’ businesses were accredited under the state’s Psychiatric Rehabilitation Program, which requires mental health providers to pass certain criteria before making reimbursement claims.

Saunders, however, was barred in 2022 from receiving payments in federal healthcare programs after a fraud conviction the year before, which stemmed from much of the same behavior as her most recent case. Ordered to pay more than $470,000 in restitution, she was also sentenced to serve nine months of incarceration, nine months of home detention and five years of supervised probation.

However, during her probation, authorities said Saunders continued the scheme by concealing her affiliation with the two companies in a Medicaid provider application.

According to court documents, Saunders, who law enforcement said, “principally directed the fraud scheme,” used the names of her relatives to avoid detection. The attorney general’s office said in a news release that nearly a dozen search warrants on email records, cloud storage accounts and cellphone data revealed a “sophisticated system” for manufacturing fake patient records.

Investigators spoke to “numerous” Medicaid recipients who had “no familiarity” with the companies or the services billed under their names, according to the release. And authorities said the defendants stole the identities of legitimate mental health providers as well, including faculty members at the University of Maryland School of Medicine.

With their information, referrals for services and rehabilitation plans could be faked and submitted for billing, the attorney general’s office said.

Higgins pleaded guilty to the two felonies Tuesday and Saunders was convicted Feb. 25, according to the Maryland Judiciary.

Defense attorney Bryan Mobley, who’s representing Higgins, declined to comment Tuesday. C. Justin Brown, who is representing Saunders, did not immediately respond to a request for comment.

In addition to McHale, Assistant Attorney General Catherine Pascale was responsible for Higgins’ and Saunders’ prosecutions.

Their convictions are far from the first cases of Medicaid fraud in Maryland — the attorney general’s office has its own Medicaid Fraud and Vulnerable Victims Unit — nor are they the first involving behavioral health providers.

Since July, the Maryland Department of Health has paused enrollment applications for certain kinds of providers, including those looking to enter the same Psychiatric Rehabilitation Program as Higgins and Saunders’ companies.

The moratorium, a measure to address fraud, waste and abuse following a spike in applications, was initially scheduled for six months but was extended to a full year in December.

Following Tuesday’s hearing in Anne Arundel County Circuit Court, it appeared possible that if the defendants adhere to the conditions of their plea agreements, the state may request neither serve jail time.

It was not immediately clear why the case was filed in Anne Arundel.

McHale said the state is asking that Higgins pay $341,900 in restitution, the amount he personally received from the scam.

When asked how much his client could be expected to pay before July’s sentencing hearing, Mobley said $10,000.

Anne Arundel Circuit Judge Stacy McCormack suggested Higgins pay more, reminding him that the state’s request for sentencing is only a request.

“You better do everything they ask you to do,” the judge said.

Have a news tip? Contact Luke Parker at lparker@baltsun.com, 410-725-6214 and x.com/@lparkernews.