LifeWorks Counseling Associates: Excluded-Clinician Claims and a Separate Criminal Case

In the LifeWorks Counseling Associates fraud case, the company and its owner paid $300,000 to resolve civil allegations that they billed New Hampshire Medicaid for services provided by an excluded clinician. The psychotherapist’s separate criminal case described counseling claims tied to occasions when he requested and received a patient’s help with personal tasks. For someone who knows the sessions, the staffing or the billing, those are concrete questions about who did the work and what Medicaid paid for.

LifeWorks Counseling Associates, PLLC is a telehealth mental health provider based in New Hampshire. The U.S. Attorney’s Office for the District of New Hampshire announced its civil settlement on December 10, 2025. A later criminal-case announcement, published January 28, 2026, confirmed that LifeWorks and its owner had paid the civil amount.

How the Excluded-Clinician Claims Worked

The government’s civil allegation was that LifeWorks and its owner submitted Medicaid claims and received reimbursement for work performed by someone excluded from federal healthcare programs. The government said the clinician was excluded when he provided the services, making those claims ineligible for reimbursement.

The civil announcement explains the payment rule directly: federal program payments cannot cover services furnished by someone excluded by the Department of Health and Human Services Office of Inspector General.

The distinction also reaches beyond a worker’s personal billing number. The inspector general’s May 2013 advisory bulletin on exclusions describes how the payment prohibition reaches covered work by excluded employees, including direct and indirect services paid through an organization. The company can receive the reimbursement while the excluded worker supplies the labor behind it.

The Excluded Clinician’s Criminal Case

According to court documents described in the Justice Department’s criminal-case announcement, the psychotherapist began working through the New Hampshire telehealth provider in March 2022. He provided services billed to New Hampshire Medicaid despite knowing he was on the exclusion list.

Those criminal court documents also described the psychotherapist causing the provider to submit counseling claims for services that were not delivered as described. Those claims included instances when he asked for, and later received, a patient’s assistance with personal tasks.

We see the absurdity in that reversal: the patient was helping the therapist, and Medicaid was being billed for counseling. Help flowing the wrong way.

The personal-task detail makes the claimed service the next question. We would compare what a treatment note described with what someone familiar with the encounter says actually happened.

The Civil Payment and the Company’s Cooperation

The clinician admitted causing New Hampshire Medicaid to pay approximately $173,998 in false claims, according to the criminal-case announcement, which reports his guilty plea to health care fraud. The company’s civil settlement resolved allegations about billing for the excluded worker’s services.

The civil settlement amount was based on LifeWorks’ and its owner’s ability to pay, according to the settlement announcement.

The civil announcement also says LifeWorks and its owner fully cooperated in the parallel criminal investigation. The government resolved allegations against the business and its owner while separately prosecuting the psychotherapist.

The Department of Health and Human Services Office of Inspector General and the FBI investigated the case.

What the Billing Organization’s Name Leaves Out

An employee who knows who actually treated a patient can see something the billing organization’s name leaves out. In behavioral health, professional qualifications concern the worker, while payer enrollment and contracts establish a reimbursement relationship. The rendering clinician connects the treatment record to the work for which the organization sought payment.

That distinction matters when the employee is visible in staffing or payroll records but the organization is the name attached to the reimbursement.

A Psychiatric Practice’s Clinical Director

In a separate case, Geriatric & Adult Psychiatry and its owner agreed to a $310,874 settlement over allegations that the practice employed an excluded clinician as its clinical director and used federal program reimbursements to fund his salary and benefits. The government alleged that the practice employed him from February 2016 through June 2021. The Justice Department announced that resolution on February 23, 2022.

At the psychiatric practice, federal reimbursements allegedly funded the clinical director’s compensation. At LifeWorks, the government alleged that Medicaid paid claims for the excluded clinician’s services. Following the money into the organization also means following the work and compensation inside it.

What Evidence Is Needed to Prove Fraud?

For excluded-clinician billing, the evidence connects the worker’s identity and exclusion status on the service date to the claim, the service represented and the payment. For falsely described counseling, it also connects the billed session to what actually happened. We work with insiders to establish those connections from their knowledge of the practice and its records.

We look at what staffing records and treatment notes say about the worker and the encounter, alongside what the claim represented. An insider’s account gives those records context: who saw the patient, what happened and how the practice described it for payment.

The service date matters throughout. In the government’s LifeWorks account, the exclusion was in effect when the clinician provided the services. Our comparison would put the worker, the exclusion and the claim on that same date, then examine what the session actually involved.

A scheduler, treating professional or billing employee may see a different part of that connection in ordinary work. Our role is to bring those perspectives together into a case about the actual claims and the decisions behind them. If your concern starts with a session described differently from what you witnessed, that is a concrete place for a conversation with us to begin.

How Much of a Settlement Does a Whistleblower Get?

A whistleblower case under the False Claims Act can pay 15% to 30% of what the government recovers. For someone inside a counseling practice, we assess how their knowledge of the work, the worker and the billing can support a whistleblower case.

You Know Who Did the Work

If you know how LifeWorks or another counseling practice turned a clinician’s work into Medicaid claims, speak to one of our Whistleblower Experts about how those claims were billed. We build your strongest whistleblower case from your knowledge of the sessions, staffing and billing, bring in behavioral health fraud whistleblower lawyers who understand provider eligibility, and stay beside you as the case develops.