Providers
All 12 in WI
JANICE SCHOLZ
NPI 1821444795, individual, Madison, WI, Behavior Analyst
5
Evidence tier
informational
- 77% of Medicaid dollars are on codes with a history of abuse.
score 33 of 100, rank 10560, $1.3M at stake
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | JANICE SCHOLZ |
| Type | Individual |
| Status | Active |
| NPI issued | May 10, 2016, last updated May 10, 2016 |
| Practice location | 1210 FOURIER DR STE 100, Madison, WI 53717-1969, 608-662-9327 |
| Specialties | Behavior Analyst (103K00000X, primary, license 148-140 WI) |
Procedures billed
The specific codes behind the dollars. Medicaid figures come from T-MSIS (2018 to 2024) and are compared with every other provider billing the same code; Medicare figures come from the 2024 physician and supplier file and compare this provider's submitted charge with what Medicare allowed, against the usual ratio for that code.
Medicaid, largest codes
| code | what it is | paid | share | per patient-month | typical | rank among providers | |
|---|---|---|---|---|---|---|---|
| 97153 | Adaptive behavior treatment by protocol by technicianhistory of abuse | $3.1M | 49% | $2K | $2K (top 5% from $6K) | 64th percentile | |
| 97155 | Adaptive behavior treatment with protocol modification by QHPhistory of abuse | $1.8M | 28% | $1K | $512 (top 5% from $1K) | 94th percentile | |
| 0365T | Adaptive behavior treatment by protocol each addl 30 min (pre-2019) | $725K | 11% | $2K | $2K (top 5% from $4K) | 67th percentile | |
| 0369T | Adaptive behavior treatment with protocol modification each addl 30 min (pre-2019) | $331K | 5% | $958 | $430 (top 5% from $971) | 93rd percentile | |
| 0364T | Adaptive behavior treatment by protocol first 30 min (pre-2019) | $146K | 2% | $424 | $303 (top 5% from $1K) | 81st percentile | |
| 0368T | Adaptive behavior treatment with protocol modification first 30 min (pre-2019) | $124K | 2% | $358 | $192 (top 5% from $534) | 86th percentile | |
| 97151 | Behavior identification assessment by professional, each 15 minutes | $52K | 1% | $172 | $389 (top 5% from $1K) | 14th percentile | |
| 97156 | Family adaptive behavior treatment guidance | $51K | 1% | $147 | $210 (top 5% from $547) | 36th percentile |
In this area
12 providers in Dane County, WI carry an indicator in the public record, with $4.4M at stake between them. The most common is more hours than a day holds, on 7 of them, followed by part of a provider network on 5.
| tier | provider | at stake | why |
|---|---|---|---|
| 3 | HOME HEALTH UNITED INC Madison, WI, ranked 1347 | $107K |
|
| 3 | OAKWOOD VILLAGE UNIVERSITY WOODS HOMES, INC Madison, WI, ranked 2061 | $0 |
|
| 3 | OAKWOOD VILLAGE PRAIRIE RIDGE HOMES, INC Madison, WI, ranked 3163 | $0 |
|
| 3 | CROSSROADS CARE CENTER OF SUN PRAIRIE LLC Sun Prairie, WI, ranked 4170 | $0 |
|
| 3 | BRISTOL HOSPICE - MADISON, L.L.C. Madison, WI, ranked 4617 | $0 |
|
| 5 | KIMBERLY KNIPPEL Madison, WI, ranked 9862 | $373K |
|
| 5 | JOSEPH PERRON Madison, WI, ranked 10134 | $891K |
|
| 5 | TIFFANY PALMBACH Madison, WI, ranked 10550 | $1.5M |
|
Recent enforcement in WI
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
DOJChargedJun 25, 2026
Federal Charges Announced in Multi-Million Dollar Medicaid Fraud Scheme and Prescription Drug Diversion Conspiracy; Announcement Made as Part of Justice Department’s National Health Care Fraud Takedown
Cooper submitted over $5.8 million in false claims to Wisconsin Medicaid for prenatal care coordination services that beneficiaries never received and used another person's means of identification, while Jones conspired to distribute controlled substances outside the usual course of professional practice.
DOJCivil settlementApr 17, 2026
Appleton Clinic to Pay Over $380,000 to Resolve False Claims Act Allegations Relating to the Marketing and Use of Electric Stimulation Devices
Apple Medical Clinic and its principal caused the submission of false claims to Medicare for electrical muscle stimulation, vitamin injections, and other related services that were not medically reasonable or necessary, and marketed the Sanexas device outside its FDA clearance and contrary to coverage determinations.
DOJSentencedMar 23, 2026
Owner of Now-Closed Milwaukee Prenatal Care Coordination Company Sentenced to 60 Months’ Imprisonment for Healthcare Fraud Scheme
Jackson offered women kickbacks in exchange for their Medicaid numbers and falsely billed Wisconsin Medicaid for prenatal care coordination services, almost always at the monthly maximum, when she and her employees provided few to no covered services.
DOJCivil settlementMar 5, 2026
Waukesha Medical Equipment Company Agrees to Pay Nearly $7 Million to Resolve Allegations of False Billings to Federal Healthcare Programs
From 2019 through 2024, Kinex provided patients covered by federal programs with medical braces the patients did not need and billed Medicare, TRICARE, FEHBP, and OWCP as if the braces had been necessary, inducing patients to accept them by waiving co-pays and giving free equipment.
DOJSentencedFeb 3, 2026
Delafield Man Sentenced to 18 Months’ Imprisonment for Conspiracy to Pay Healthcare Kickbacks
Johnson paid kickbacks to companies purporting to provide marketing services in exchange for signed prescriptions and doctors' orders for durable medical equipment that his company Kestrel Medical submitted to Medicare.
Referral packet
The packet is a draft for a reviewer. It reads every public record behind this case, states what the records show with a citation for each finding, names the regulation each finding relates to, and lists the ordinary explanations to rule out first. It never asserts intent.