Sumter woman faces federal charges in $9M fraud scheme

A co-founder of Sumter-based Early Autism Project Inc. is facing the possibility of having to pay $9 million if she is convicted of embezzling money from Medicaid and TRICARE, an accusation the organization itself settled in 2018.

An indictment from a grand jury states Susan A. Butler, a Sumter native, and others planned and systematically conducted a scheme to defraud TRICARE and Medicaid by over-billing the agencies for autism-related and other services between January 2007 and June 2016.

At the time relevant to the indictment, Butler was a founder, owner and operator of EAP, states the indictment. Butler helped found the group in 1995 after seeking behavioral therapy for her son, who was diagnosed with autism at a young age.

EAP now has clinic sites throughout the state and affiliates in Georgia, Florida and Pennsylvania, serving hundreds of children.

In the first count of the grand jury's indictment, Butler is accused of fraudulently billing the government for administrative costs, including therapist travel expenses, that were disguised as patient therapy. The alleged fraudulent billings also included costs for services that were not rendered.

The second count of the indictment accuses Butler of knowingly and willingly embezzling, stealing and converting to other uses the alleged fraudulent money totaling $9,020,589.56.

This is the second suit related to fraudulent activity conducted by EAP since a lawsuit was filed against the organization in 2015 for submitting false claims to the same medical insurance companies.

On Aug. 2, 2018, the United States Attorney's Office for the District of South Carolina announced that EAP paid the United States $8,833,615 to resolve a False Claims Act investigation regarding the submission of false claims to Tricare and South Carolina Medicaid programs for therapy services that were misrepresented and not provided.

EAP was accused of padding billable time for a therapist who had not actively worked with children during those listed hours.

The investigation started when a former employee, Olivia Zeigler, filed a lawsuit under the whistleblower provisions of the False Claims Act in July 2015. Under the act, Zeigler received $435,000 after the U.S. recovered money from the settlement.