Clients, co-workers, a state Medicaid fraud specialist and an investigator in the Kansas Attorney General’s office took the stand for the prosecution Tuesday during the first full day of testimony in the trial of Vivian Mundy.
Mundy is on trial for multiple felony counts of defrauding Medicaid of between $158,000 and about $200,000 through billings by her company, Cognitive Care Connections, which had offices in Emporia and Topeka. Mundy and her employees worked with people with traumatic brain injuries.
Former employee Hannah Laspisa said that she had become suspicious that Cognitive Care Connections was billing for services that had not been provided. Laspisa had been a personal care attendant for the company and later was an office assistant, then office manager.
“We had numerous complaints from several different consumers that their therapist and/or (transitional living specialist) was not showing up, yet services were still being billed for,” Laspisa said.
She testified that around mid-October of that year, Mundy had asked that incorrect information or overlapping times on time sheets or notes be whited-out on the original documents. Laspisa said Mundy had told her to copy the corrected document, then fill in the correct information.
“Then we would turn that in as the original document, and then shred the original,” she said.
Assistant Attorney General Jabari Wambel, who is prosecuting the case, asked what the purpose of shredding was, and Laspisa replied “So that there was no proof.”
“So you were trying to mislead the state?” Laspisa said.
“Yes, sir.”
“She wanted you to take what was wrong and make it right?” he asked.
“Yes,” she said.
Defense attorney Tom Haney asked Laspisa if she had a civil suit pending against Mundy for wages due her from her employment by Cognitive Care.
Laspisa said that she had contacted the state labor board because Mundy owed her approximately $1,100.
Under questioning by Haney, Laspisa said that Mundy had paid some money to a few employees with personal checks on occasion. The state had stopped paying all of Cognitive Care’s billings, and employees had been told that money was not available to pay them.
The situation became the topic of a forum on the Internet.
During cross-examination, Laspisa said the attorney general’s office had contacted her as the result of something that had been posted on a forum on CJOnline, the Topeka Capital Journal’s online newspaper.
Another former Cognitive Care employee, Amanda Law, said that Mundy had asked her to change billing information for a consumer named Evelyn.
“But she asked me to go in and double or almost triple the time ... so she could backbill for it,” Law said.
Law left a note on the paperwork for the program manager for the state who approved billings, and told him that “I was doing all that under Vivian’s direct order.”
Law said that she had a document in her computer that detailed a series of events and a timeline of happenings at Cognitive Care, and that she provided a hard copy of it to the attorney general’s investigator.
Law responded “Yes,” when Haney asked if she was aware that Mundy had said she was going to sue Law.
“Did the attorney general’s office tell you during your interview that they thought you had violated the law?” Haney asked.
“No,” Law said.
Julia, one of Mundy’s former clients, testified that her sessions with Mundy often involved the defendant running personal errands or shopping, both in Emporia and in Topeka. The Gazette will not fully identify clients who testify, to protect the privacy of their health conditions.
Julia became involved with Cognitive Care after undergoing surgery, chemotherapy and radiation for a brain tumor and for damages caused during an abusive relationship. Julia said she did not feel she had received therapy during her sessions with Mundy.
“Not at all,” Julia said. “I don’t believe going to Walmart to pick up her dinner is therapy. I don’t believe going on out-of-town shopping trips is therapy. And I certainly don’t believe that being drug around by the arm and being talked down to is therapy.”
She said Mundy had taken her to Lowe’s, Best Buy, Walmart Super Center and other stores for Mundy’s personal shopping needs and that “listening to her complain about her life, I didn’t feel was therapeutic to me. I felt it was very stressful.”
Julia said that Mundy had mentioned feeling overwhelmed and that she didn’t have enough time to see clients individually.
“That’s why I was taken to see another girl, Tammy, and she would see Tammy and I at the same time but she wasn’t paying attention to either of us,” she said.
“I checked into her references when I finally got fed up with it,” Julia said.
She testified that the day after she fired Mundy, Mundy burst into her house as Julia was sitting with her transitional living specialist and a friend.
“Vivian comes in and starts screaming and ranting. ‘How dare you go and check my references? Who do you think you are?’” Julia paraphrased Mundy.
Julia said Mundy went through bills on the table while the TLS worker asked Mundy to leave.
Mundy told Julia to sign Mundy’s sister’s time sheets without looking at them, and Julia complied.
“She threatened me. She said she had the power to send me to Osawatomie mental hospital,” Julia said. “I signed them because she said she had the power to send me to Osawatomie. I’m not insane, but that scared the hell out of me.”
Julia testified that Mundy also threatened her with loss of access to the traumatic brain injury program and intimated that the woman would lose her disability benefits of $640 a month.
“And these last 10 years have been very difficult,” Julia said, beginning to cry. “I have no intention of remaining on disability forever but right now, it’s my only means of income.”
She said under cross-examination by Haney that she believed Mundy had taken a career to help people and had turned it into a way to hurt people.
“So my question is, do you not like Vivian Mundy?” Haney asked.
“Not any more,” Julia responded.
Camilla McKinney of the fraud division of the attoney general’s office and the AG’s office investigator Mark Montague both testified about their investigations into Mundy’s billings and documents regarding services under Medicaid.
Each had drawn up spreadsheets outlining an assortment of discrepancies they said they’d found in original, subpoenaed,and re-submitted documents from Cognitive Care Connections.
McKinney had gone through 20,000 to 25,000 claims from Mundy and other providers over a multi-year period and had broken the claims and figures out into an assortment of categories.
Among the information McKinney testified to were Medicaid overpayments to Cognitive Care that included:
- $75,546.44 in overbillings for driving time,
- $62,656.14 in overbillings for service times that overlapped other service providers, and
- $17,963.86 in overpayments for times Mundy allegedly was shopping while billing for providing services to clients.
Haney pointed out that some of the figures had been listed in more than one category and had been counted twice on the spreadsheets. He questioned whether the drive time, which might be minutes, had been charged as an entire session on McKinney’s records.
He also noted under cross-examination that Mundy had underbilled in 45 instances, losing $734.52 that might have been billed. Thirty-one of those underbillings contained errors, McKinney said.
Mundy also had not billed for services in 118 instances, with $7,550 that potentially could have been paid to her company.
McKinney explained that those were not included in the spreadsheets.
“I think part of the problem is the defendant can rebill these services,” she said.
Investigator Montague presented a number examples of of recapitulations, changes or amendments to Medicaid billings that Mundy had submitted for processing; billings subsequently submitted because of a subpoena showed changes had been made in the original billings.
Montague also testified about records of Mundy’s activities on specific days, in which she had billed Medicaid for times that the prosecution alleges showed appointments that were not possible. Montague used Mundy’s K-tag records and bank records to challenge the accuracy of her billings.
After listing a chronological order pieced together for one of Mundy’s work days, Montague said that the defendant billed Medicaid for providing 18 hours of services to clients in one day.
Additionally, the clients were in separate towns and some of the appointments overlapped. With a total of 410 miles that would have been driven to see clients that day, in approximately seven hours and 42 minutes of driving time, and the 18 hours of billed service times, Montague said Mundy’s day was 25 hours, 42 minutes long.
Montague showed similar examples for each of the years covered in the case.
Haney questioned why Montague had not told Mundy that he had a subpoena ready for her when she came to the AG’s office to talk about billing discrepancies.
“You wanted to find out everything she had to say and then, a subpoena?” Haney asked.
“Absolutely,” Montague said.
“And you didn’t tell her she had the right to have an attorney there, did you?” Haney asked.
“I did not,” Montague said. “I usually do that, that’s true.”
Montague said he had not been in the office when Mundy arrived and had joined her and McKinney for the meeting.
“That was an oversight on my part,” Montague said.
create (anonymous) says...
For want of a nail the whole house caved in?
I hope Montague's "oversight" doesn't lose the entire case.
March 3, 2010 at 2:59 p.m. ( permalink | suggest removal )
native_emporia (anonymous) says...
What will lose the case for the AG's office is their lack of real proof and that the majority of their case is based on testimony from individuals with serious brain injuries. If you do the research on trauma to the brain it is evident that these individuals lack the ability to remember things properly and deal with serious anger issues in many cases. Thus, they do not make creditable witnesses.
I have known Vivian for many years and am sure mistakes were made in her paperwork. She is a caring, compassionate individual that lacks the organization needed to keep accurate records properly. I think she is guilty of very poor record keeping, but not of intentionally defrauding the state.
My family wishes her the best
March 3, 2010 at 4:49 p.m. ( permalink | suggest removal )
camerashy (anonymous) says...
While the State of Kansas faces a huge budget crisis we are wasting valuable dollars on investigating and prosecuting this case. Mundy has not learned a lesson, will never have the money to pay the state back for the fraud and we'll pay even more for her prison time. All because one person thought she was invincible and above the rules/law. Very sad.
March 4, 2010 at 1:12 a.m. ( permalink | suggest removal )
toninj (anonymous) says...
It is sad that this money has been wasted. I am sure more has been spent on this case then the amount the state thinks it is owed.
I sat in court during the prosecution part of this case and can say it is a HUGE waste of tax dollars that has been spent on investigating and state attorney costs. There is no case, this woman obviously just kept poor records, but the state has not proven any real crime was committed. They never showed that she thought she was "invincible and above the rules/law".
March 4, 2010 at 11:30 a.m. ( permalink | suggest removal )
genxer (anonymous) says...
I would like to know what qualifications this person has for rehabilitating people with serious head trauma! What does a person have to do to be able to treat people in that condition, just set up a business and apply for funds?
I used to live near her and quite frankly, I thought she was unemployed and living off of welfare or disability or something. I never in my wildest imagination would have guessed that our government was trusting her with hundreds of thousands of taxpayer dollars.
It's no wonder medicare and medicaid are bankrupt!!!
March 4, 2010 at 11:32 a.m. ( permalink | suggest removal )
create (anonymous) says...
I'm with you, genexer. This woman scammed the system, pure and simple. Sounds like you can get away with it by just keeping bad records. What a bunch of bunk.
Multiply this case by hundreds, even thousands around the country and yes, it's no damn wonder medicare and medicaid is boing broke.
What we need is closer investigation. How did this woman get by with keeping bad records for so long?
How did she get by with dragging patients to shopping trips?
This investigation didn't go deep enough.
March 4, 2010 at 12:14 p.m. ( permalink | suggest removal )
Landa (anonymous) says...
are you kidding? They have LOTS of proof. bank records, K tag records, they could probably pull video from stores she was shopping in while she billed Medicaid. I know a girl that worked for Vivian, and these are EXACTLY the kinds of things she told me about. So, Native_Emporia, just so you know, you don't always know someone as well as you think you do. And the comment about people with brain injuries - just so you know, the clients were not the ones who brought Vivian to the attention of the court, her billings were. They are simply there to testify. The reality of it is, the patients never see the billing. It goes directly to medicare/medicaid. Get your facts straight.
March 4, 2010 at 12:20 p.m. ( permalink | suggest removal )
SFIns (anonymous) says...
This all comes down to bad people do bad things. You can try to justify it however you want but it is only human nature for some people to try and cheat whenever they can.
March 4, 2010 at 1:10 p.m. ( permalink | suggest removal )
genxer (anonymous) says...
I think the biggest part of this story is not that someone is scamming medicare, we're all painfully aware that is happening.
To me the biggest part of the story is what the federal goverment considers as qualifications for performing these types of services. Perhaps Vivian is a licensed Physcial or Mental therapist and I'm not aware of it. If not, what is she doing getting paid that kind of money to work with people who need REAL help from someone who knows what they're doing???
March 4, 2010 at 3:34 p.m. ( permalink | suggest removal )
orlando (anonymous) says...
If it was known that she was a bad bookkeeper, why didn't she hire a bookkeeper or an accountant? Maybe that person would have discovered what she was doing?
She finds an uncashed check 3 years old in her desk last year? Was she paying her taxes?
March 4, 2010 at 6:59 p.m. ( permalink | suggest removal )
biscuitboy (anonymous) says...
I do not know this woman...have never even met her....nor do I know what she looks like. The only thing I know about this case is what I have read in the newspaper. Based only on that information...with no misplaced loyalty or an axe to grind.....I say guilty as charged.
March 4, 2010 at 7:16 p.m. ( permalink | suggest removal )
koalemos (anonymous) says...
Funny that the former employee's didn't get charged as well. They admitted to partaking in filing fraudulent claims like a pirate crew and only came forward when they didn't get their share of the pirate treasure, plunder or other ill-gotten gains.
March 4, 2010 at 7:24 p.m. ( permalink | suggest removal )
msw2003 (anonymous) says...
To genxer
Vivian is an LMSW (licensed master level social worker) which is why she is able to bill medicaid for her services as a mental health provider who specialized in treating people with traumatic brain injuries. This means she has a Masters Degree in Social Work and had a pass a national licensing exam to become an LMSW.
March 5, 2010 at 10:22 a.m. ( permalink | suggest removal )
create (anonymous) says...
Licensing and masters degrees do not a decent person make. Sounds to me like the only thing she really specialized in was deceit. She deceived the state, her employees, and worst of all, her helpless clients. Shame!
March 5, 2010 at 10:42 a.m. ( permalink | suggest removal )
seriouslyfolks (anonymous) says...
Pretty soon the government is going to have more programs and agencies for people to scam and they will do very little to stop the fraud.
March 5, 2010 at 11 a.m. ( permalink | suggest removal )
Steve_Corbin (anonymous) says...
Gosh, the sloppy bookkeeping excuse is funny considering we are all fighting about budgets and the effects of cuts in schools and education.
And this woman has a MASTERS DEGREE?
March 5, 2010 at 2:09 p.m. ( permalink | suggest removal )
camerashy (anonymous) says...
Guilty on 6 of 8 counts....and it took 6 years.
March 7, 2010 at 2:25 p.m. ( permalink | suggest removal )