State Enforcement Actions
State Enforcement Archive
December 2018
- December 18, 2018; Florida Attorney General
- Attorney General Bondi's Medicaid Fraud Control Unit Secures $5 Million Settlement with Hospital Chain
TALLAHASSEE, Fla.-Attorney General Pam Bondi today announced a multimillion dollar settlement with former hospital chain Health Management Associates, LLC. The settlement resolves allegations that during the period of 2003 through 2011, two HMA hospitals, Charlotte Regional Medical Center and Peace River Medical Center, billed the Florida Medicaid program for services referred by physicians to whom HMA provided remuneration in return for patient referrals.
- December 12, 2018; Tennessee Department of Finance and Administration
- Lake County Woman Charged with TennCare Fraud
NASHVILLE, Tenn. - A Lake County woman is the fourth person charged with TennCare fraud in connection with a round-up that took place last month involving the Office of Inspector General (OIG), the 29th Judicial Drug Task Force, Tiptonville Police Department and the Lake County Sheriff's Office.
- December 7, 2018; North Carolina Attorney General
- Attorney General Josh Stein Announces Two Medicaid Behavioral Health Fraud Convictions
(RALEIGH) Attorney General Josh Stein today announced that Lisa Carol Raymond of Greenville, North Carolina, and Robert Paul Maglicic, Jr., of Miami, Florida, pleaded guilty to Conspiracy to Commit Health Care Fraud in the United States District Court for the Eastern District of North Carolina.
- December 3, 2018; Georgia Attorney General
- Carr: Georgia Resident Indicted for Medicaid Fraud and Elder Exploitation in Gwinnett County
ATLANTA, GA - The Office of the Attorney General today announced that Quanicia Wilson was indicted on November 7, 2018 for the following charges: one count of Violation of the Georgia Racketeer Influenced and Corrupt Organizations Act, five counts of Medicaid Fraud, one count of Exploitation of an Elder Person, one count of Forgery, one count of False Statements and Writings and twenty-two counts of Theft by Taking. The case was presented in Gwinnett County Superior Court.
November 2018
- November 29, 2018; Colorado Attorney General
- Attorney General Coffman Announces Conviction and Sentencing of Speech Pathologist who Fraudulently Billed Medicaid for over $1.2M
DENVER-Colorado Attorney General Cynthia H. Coffman today announced that Tara L. Rose a Speech Language Pathologist in El Paso County, has pled guilty to one count of Class 3 felony theft and one count of Class 4 felony theft. The charges stemmed from $1.2 million in fraudulent billing that Rose and her company, Beyond Words LLC, submitted to the Colorado Department of Health Care Policy and Financing (HCPF). The court accepted her plea and the parties argued sentencing before the Court. Rose was sentenced to a term of eight years in Colorado Community Corrections on the first charged count and to a ten year term of probation on the second count that is to run consecutive to the first. Rose was also ordered to pay $1.28 million in restitution to HCPF.
- November 28, 2018; Oklahoma Attorney General
- Behavioral Health Counselor Sentenced to Prison in Fraud Case
OKLAHOMA CITY - A former behavioral health counselor has been sentenced to a year in prison for Medicaid fraud, after a collaborative effort between Attorney General Mike Hunter's Medicaid Fraud Control Unit and the U.S. Attorney for the Western District of Oklahoma's office, led by Robert J. Troester.
- November 20, 2018; Nevada Attorney General
- Rutledge Announces Arrest of Hot Springs Employee for Billing Medicaid for Family
LITTLE ROCK - Arkansas Attorney General Leslie Rutledge today announced the arrest of a Garland County woman for Medicaid fraud.
- November 21, 2018; U.S. Attorney; Middle District of Louisiana
- Baton Rouge Doctor Pleads Guilty to Conspiring to Receive Health Care Kickback Payments
BATON ROUGE, LA - United States Attorney Brandon J. Fremin announced today that GRAY WESLEY BARROW, age 58, of Baton Rouge, Louisiana, pled guilty for his role in a scheme to receive approximately $336,000 in illegal health care kickback payments. As a result of his conviction, BARROW faces a significant term of imprisonment, restitution and fines, and a period of supervised release.
- November 20, 2018; Georgia Attorney General
- Carr: Georgia Residents Plead Guilty to Medicaid Fraud in Augusta
ATLANTA, GA - The Office of the Attorney General today announced that defendants Luvinia Nipple and Margaret Rivers pled guilty to one count of Medicaid Fraud on November 16. A Richmond County judge sentenced Luvinia Nipple to serve 10 years of probation and pay restitution in the amount of $112,532.38. Margaret Rivers, for her part in the scheme, was sentenced to three years of probation.
- November 19, 2018; Tennessee Department of Finance and Administration
- Dickson Co. Fugitive in Custody on TennCare Fraud Charges
NASHVILLE, Tenn. - After being on the run for 14 months, a Dickson County woman is now in custody and charged with TennCare fraud for selling prescription drugs paid for by the state's healthcare insurance program.
- November 13, 2018; Arkansas Attorney General
- Rutledge Announces Medicaid Fraud Arrests Involving Falsified Documents and Stolen Hydrocodone
LITTLE ROCK - Arkansas Attorney General Leslie Rutledge today announced the arrest of a Cross County woman for Medicaid fraud and a Pulaski County woman for fraudulently obtaining a controlled substance.
- November 8, 2018; New York Attorney General
- A.G. Underwood Announces Arrests Of Niagara Falls Taxi Company Owner And Employees For Allegedly Defrauding Medicaid
NIAGARA FALLS - Attorney General Barbara D. Underwood today announced the arrests of Sadat Khan, 29, Kashif Pervez, 36, Marcus Mathis, 41, Chester Haugabook, 48, and William Medina, 35, all of Niagara Falls, for their roles in an alleged scheme to steal over $50,000 from Medicaid by paying off Medicaid recipients in order to fraudulently bill for transport rides. The Attorney General's ongoing investigation into Medicaid transit scams - dubbed "Operation Ghost Ride" - revealed that Wego Taxi Tours, Inc. submitted claims and received payment from Medicaid for rides that were not provided as claimed.
- November 8, 2018; North Carolina Attorney General
- Attorney General Josh Stein Announces Medicaid Fraudster Sentenced
(RALEIGH) Attorney General Josh Stein today announced that Renee Christine Borunda of Greensboro was sentenced to 37 months in federal prison following her guilty plea to Conspiracy to Commit Health Care Fraud and Aggravated Identity Theft. Borunda will also make restitution of $225,399.08 to the North Carolina Medicaid Program.
- November 8, 2018; Kansas Attorney General
- Dickinson County woman ordered to repay more than $2,500 for Medicaid fraud
ABILENE - (November 8, 2018) - A Dickinson County woman was ordered yesterday to repay more than $2,500 to the Kansas Medicaid Program after pleading guilty to Medicaid fraud-related charges, Kansas Attorney General Derek Schmidt said.
- November 5, 2018; Tennessee Department of Finance and Administration
- Weakley Co. Woman Charged with TennCare Drug Fraud
NASHVILLE, Tenn. - A Weakley County woman is charged with TennCare fraud in connection with selling prescription drugs she obtained using TennCare healthcare insurance benefits.
October 2018
- October 30, 2018; Kentucky Attorney General
- Beshear: Jefferson County Couple Charged with Alleged Neglect/Abuse, Medicaid Fraud
FRANKFORT, KY. (Oct. 30, 2018) - A Jefferson County couple is facing six felony counts of alleged abuse and neglect of a vulnerable Kentuckian, and theft and fraud of the Kentucky Medicaid Program, according to Attorney General Andy Beshear.
- October 30, 2018; New York Attorney General
- A.G. Underwood Announces Arrest Of Suffolk County Doctor For Lab Testing Scheme
HAUPPAUGE - Attorney General Barbara D. Underwood today announced that a Suffolk County medical doctor, Edwardo M. Yambo, 70, of Lake Grove, has been arrested and charged (together with his company, Edwardo Yambo, P.C.), with Grand Larceny in the Second Degree, a class C felony.
- October 23, 2018; Oklahoma Attorney General
- Attorney General Hunter Files Financial Exploitation Charges on Nursing Home Administrator, Accused of Taking More than $217,000 from Elderly Resident
OKLAHOMA CITY - Attorney General Mike Hunter has filed financial exploitation charges on the former nursing home administrator of Drumright Nursing Home, who allegedly diverted more than $217,000 from at least 33 elderly residents.
- October 16, 2018; New York Attorney General
- A.G. Underwood Announces Convictions Of Three Nassau County Nursing Home Staff For Neglect Of 81-Year-Old Ventilator-Dependent Resident
HAUPPAUGE - Attorney General Barbara D. Underwood today announced the convictions of two registered nurses, Sijimole Reji and Annieamma Augustine, and a certified nurse aide, Martine Morland, for neglecting an 81-year-old ventilator-dependent resident of A. Holly Patterson Extended Care Facility in Uniondale. The resident lived on a specialized ventilator unit at the facility. She required a mechanical ventilator to breathe and was entirely dependent on the nursing staff; on the day in question, the resident became disconnected from the ventilator and passed away after the incident.
- October 16, 2018; New York Attorney General
- A.G. Underwood Announces Sentencing Of Transportation Company, President, And Driver For Stealing $1.2 Million From Medicaid
BUFFALO - Attorney General Barbara D. Underwood today announced that 716 Transportation, Inc., a Medicaid medical transportation provider, and its President Wossen Ambaye were sentenced today for stealing $1.2 million from the Medicaid program. Ambaye was sentenced to three years' conditional discharge and 150 hours of community service by Erie County Supreme Court Judge John Michalski. 716 Transportation was sentenced to pay a fine of $10,000. As a condition of his plea, Ambaye was also required to pay $900,497 in restitution to the state.
- October 8, 2018; Tennessee Department of Finance and Administration
- Obion Co. Woman Charged, Convicted of TennCare Drug Fraud
NASHVILLE, Tenn. - An Obion County woman is charged with TennCare fraud in connection with selling prescription drugs she obtained using TennCare benefits.
- October 8, 2018; Nevada Attorney General
- Attorney General Laxalt Announces Sentencing of Medicaid Provider
Las Vegas, NV - Nevada Attorney General Adam Paul Laxalt announced that Shanique Shanta Poole, 25, of Las Vegas, was sentenced today in a Medicaid fraud case involving the failure to maintain proper documentation for services provided to Medicaid recipients.
- October 4, 2018; U.S. Attorney; Western District of Pennsylvania
- Greensburg Doctor Charged with Illegally Distributing Controlled Substances and Health Care Fraud
PITTSBURGH, PA - A family practice physician has been indicted by a federal grand jury in Pittsburgh on charges of unlawfully dispensing controlled substances and health care fraud, United States Attorney Scott W. Brady announced today.
- October 4, 2018; Nevada Attorney General
- Attorney General Laxalt Announces Sentencing of Medicaid Provider
Las Vegas, NV - Nevada Attorney General Adam Paul Laxalt announced that Mikisha Renee Todd, 44, of Las Vegas, was sentenced today in a Medicaid fraud case involving the failure to maintain proper documentation for services provided to Medicaid recipients.
- October 1, 2018; Kentucky Attorney General
- Owner fraudulently billed Kentucky Medicaid for laboratory services
FRANKFORT, KY. (Oct. 1, 2018) - A 44-year-old Indiana medical laboratory owner has been indicted on two felony counts involving theft and fraud of the Kentucky Medicaid Program, Attorney General Andy Beshear announced today.
September 2018
- September 26, 2018; Tennessee Department of Finance and Administration
- Meigs County Woman Charged Sixth Time with TennCare Fraud
NASHVILLE, Tenn. - A Meigs County woman is now facing her sixth round of TennCare fraud charges.
- September 26, 2018; U.S. Attorney; Western District of Oklahoma
- Behavioral Counselor Sentenced for Fraudulent Medicaid Billing
OKLAHOMA CITY - JOHN CLARENCE BRADLEY, 49, of Oklahoma City, has been sentenced to 24 days of weekend jail confinement and five years of probation for defrauding Medicaid, announced Robert J. Troester of the U.S. Attorney's Office and Oklahoma Attorney General Mike Hunter.
- September 26, 2018; U.S. Attorney; District of Wyoming
- Psychologist and his wife plead guilty to defrauding Wyoming Medicaid
Dr. John R. Sink, Jr., who is a Ph.D. psychologist, and his wife Diane M. Sink pled guilty on September 25, 2018 before Federal District Court Judge Alan B. Johnson in federal court in Cheyenne to making false statements to Wyoming Medicaid as part of a scheme to fraudulently bill Medicaid for alleged mental health services. U.S. Attorney for the District of Wyoming Mark A. Klaassen, whose office prosecuted the case, announced the guilty pleas.
- September 25, 2018; U.S. Attorney; District of Alaska
- Anchorage Woman Who Defrauded Alaska Medicaid Program Sentenced to Federal Prison
Anchorage, Alaska - U.S. Attorney Bryan Schroder announced that an Anchorage woman was sentenced yesterday by Chief U.S. District Judge Timothy Burgess to serve eight months in federal prison for defrauding the state of Alaska Medicaid Program out of $90,000.
- September 24, 2018; Kentucky Attorney General
- Beshear: Four St. Elizabeth Healthcare Caregivers Indicted for Alleged Abuse
FRANKFORT, KY. (Sept. 24, 2018) - Attorney General Andy Beshear and his Office of Medicaid Fraud and Abuse today announced the indictment of four caregivers at St. Elizabeth Healthcare Edgewood Campus for alleged abuse of a patient.
- September 17, 2018; Connecticut Division of Criminal Justice
- Newtown Psychologist Charged in Scheme to Defraud Medicaid
Authorities tipped off by a former employee today arrested a Newtown psychologist on charges that she bilked the Medicaid program out of thousands of dollars for services she never performed.
- September 17, 2018; Arkansas Attorney General
- Rutledge Announces Three Arkansans Sentenced for Medicaid Fraud and Abuse of an Impaired Person
LITTLE ROCK - Arkansas Attorney General Leslie Rutledge today announced the conviction of a northwest Arkansas woman on Medicaid fraud charges. A Pulaski County man and a Drew County man have also been convicted on abuse of an impaired person charges.
- September 17, 2018; Connecticut Attorney General
- Newtown Psychologist Charged in Scheme to Defraud Medicaid
Authorities tipped off by a former employee today arrested a Newtown psychologist on charges that she bilked the Medicaid program out of thousands of dollars for services she never performed.
- September 11, 2018; Connecticut Attorney General
- State Sues Florida-Based Compound Pharmacy, Former and Current State Employees, Alleging Illegal Kickback Scheme
The state has initiated a lawsuit alleging violations of the Connecticut False Claims Act orchestrated through a kickback pyramid scheme involving a Florida-based compounding pharmacy and several individuals, including former and current Connecticut state employees, whose prescription drug costs are covered by the taxpayer-funded Connecticut Pharmacy Benefit Plan, Attorney General George Jepsen said today.
- September 12, 2018; New York Attorney General
- A.G. Underwood Announces $1.65 Million Joint State-Federal Settlement With Centers Plan For Healthy Living Over False Medicaid Billing
NEW YORK - Attorney General Barbara D. Underwood announced today a joint state-federal settlement with Centers Plan for Healthy Living LLC ("Centers Plan") over allegations that its managed long-term care plan ("Centers Plan MLTCP") submitted fraudulent requests to New York's Medicaid program for monthly premiums, violating the state and federal False Claims Acts. New York's Medicaid program will receive $1.65 million in restitution and penalties from the settlement.
- September 12, 2018; New York Attorney General
- A.G. Underwood Announces Guilty Pleas Of Former Focus Otsego Nursing Home Operators For Endangering Resident
COOPERSTOWN - Attorney General Barbara Underwood today announced the guilty pleas of Joseph Zupnik, former corporate owner and operator of Focus Rehabilitation and Nursing Center (Focus Otsego), and Daniel Herman, former Focus high managerial agent, for endangering the welfare of an incompetent or physically disabled person. Herman and Zupnik's guilty pleas included admissions that between May 28, 2016 and June 1, 2016, they recklessly acted in a manner likely to be injurious to the physical, mental, or moral welfare of a person unable to care for themselves because of physical disability. The defendants also admitted to failing to provide sufficient staff to provide the necessary care for one Focus resident, including, but not limited to, nutrition, medications, and incontinence care.
- September 7, 2018; Arkansas Attorney General
- Rutledge Announces Arrest of Two Arkansas Women for Medicaid Fraud
LITTLE ROCK - Arkansas Attorney General Leslie Rutledge today announced the arrest of Crittenden County and Desha County women.
- September 5, 2018; Arkansas Attorney General
- Rutledge Announces Arrest of Warren Dentist for Medicaid Fraud
LITTLE ROCK - Arkansas Attorney General Leslie Rutledge today announced the arrest of a Bradley County dentist.
August 2018
- August 28, 2018; Kentucky Attorney General
- Pretrial conference scheduled for November 15 in Jefferson Circuit Court
FRANKFORT, Ky. (Aug. 28, 2018) - Attorney General Andy Beshear and his Office of Medicaid Fraud and Abuse announced the arraignment of a Louisville woman on Medicaid fraud and theft charges.
- August 22, 2018; U.S. Attorney; Middle District of Louisiana
- Louisiana Pharmacist Convicted of Trafficking and Selling Stolen Medication
United States Attorney Brandon J. Fremin announced today the conviction of ALVIN WATTS, III, a 37-year-old resident of Addis, Louisiana. Watts was indicted by a federal grand jury on September 7, 2016 and charged in a multicount indictment. Count One charges the defendant with Conspiracy to Possess, Transport and Traffic in Embezzled Pre-Retail Medical Products and Stolen Property, Count Two charges Trafficking in Stolen and Embezzled Pre-Retail Medical Products, Count Three charges Transportation of Stolen Property, and Count Four charges Receipt, Possession, Concealment, Storage, and Sale of Stolen Property.
- August 20, 2018; Tennessee Department of Finance and Administration
- Dyer County Woman Charged with TennCare Fraud
NASHVILLE, Tenn. - A Dyer County woman is charged with TennCare fraud involving doctor shopping, or using the state's healthcare insurance program to go to multiple providers to obtain controlled substances.
- August 20, 2018; Missouri Attorney General
- AG Hawley Announces Medicaid Investigation Leads to Guilty Plea in DeBrodie Case
Jefferson City, Mo. - Missouri Attorney General Josh Hawley today announced that a joint- state and federal investigation led to the guilty plea of Melissa Denise DeLap, 49, of Columbia, Mo. DeLap plead guilty in federal court to health care fraud.
- August 20, 2018; Massachusetts Attorney General
- Three Indicted for Alleged Scheme to Defraud MassHealth
Fall River - Three people were indicted in connection with a scheme to fraudulently bill the state's Medicaid Program (MassHealth) for personal care attendant (PCA) services that were not provided, Attorney General Maura Healey announced today.
- August 16, 2018; Kentucky Attorney General
-
Henry County Resident Indicted, Charged with Health Care Fraud
FRANKFORT, Ky. (Aug. 16, 2018) - Attorney General Andy Beshear and his Office of Medicaid Fraud and Abuse today announced the indictment of a Henry County woman on health care fraud involving her son's care.
- August 14, 2018; U.S. Attorney; Northern District of Iowa
- ER Nurse Who Stole Patient Pain Medications Pleads Guilty
A registered nurse who used patient identities to steal hydrocodone pain pills while employed in a hospital emergency room pled guilty August 13, 2018, in federal court in Cedar Rapids.
- August 10, 2018; Arkansas Attorney General
- Rutledge Announces Arrest of Farmington Woman for Stealing Opioids
LITTLE ROCK - Arkansas Attorney General Leslie Rutledge today announced the arrest of a Washington County woman.
- August 9, 2018; Tennessee Department of Finance and Administration
- Monroe Co. Woman Charged with TennCare Fraud
NASHVILLE, Tenn. - A Monroe County woman is charged in nearby McMinn County with fraudulently obtaining TennCare benefits by falsely claiming her child as a dependent in order to qualify for the state's healthcare insurance program.
- August 9, 2018; Kentucky Attorney General
- Beshear, Federal Authorities Secure Health Care Fraud Pleas in Breathitt County
FRANKFORT, Ky. (Aug. 9, 2018) - A Breathitt County ambulance company, its owner and two employees have pleaded guilty to health care fraud in federal court, Attorney General Andy Beshear and his Office of Medicaid Fraud and Abuse announced today.
- August 8, 2018; Tennessee Department of Finance and Administration
- Crockett County Woman Charged with TennCare Drug Fraud
NASHVILLE, Tenn. - A Crockett County woman is charged in Madison County with TennCare fraud involving doctor shopping, or using the state's healthcare insurance program to obtain controlled substances by visiting multiple physicians.
- August 7, 2018; Massachusetts Attorney General
- Quincy-Based Dentist Indicted for Allegedly Defrauding MassHealth
Boston - A Quincy-based dentist who was banned from the state's Medicaid program has been indicted in connection with an alleged scheme to fraudulently bill MassHealth under another dentist's name, Attorney General Maura Healey announced today.
- August 6, 2018; U.S. Attorney; Western District of Virginia
- Nurse Practitioner Sentenced for Illegally Prescribing Drugs at Substance Abuse Treatment Program
Abingdon, VIRGINIA - An Abingdon Nurse practitioner, who illegally distributed opiates and other prescription drugs while working at a substance abuse program, was sentenced last week to serve 60 months in prison, United States Attorney Thomas T. Cullen and Virginia Attorney General Mark Herring announced.
- August 3, 2018; Massachusetts Attorney General
- Jury Convicts Home Health Agency Owner on All Charges for Stealing Millions from MassHealth
Boston - After a nine-day jury trial, the owner of a Boston-based home health agency has been convicted on seven charges of Medicaid Fraud and Larceny for stealing millions from the State's Medicaid Program (MassHealth), Attorney General Maura Healey announced today.
- August 2, 2018; Arkansas Attorney General
- Rutledge Announces Arrest of Clinton Woman for Stealing Opioids
LITTLE ROCK - Arkansas Attorney General Leslie Rutledge today announced the arrest of a Van Buren County woman.
- August 1, 2018; U.S. Attorney; Western District of Virginia
- Lebanon Doctor Convicted of Federal Drug Distribution Charges Following Two Week Jury Trial
Abingdon, VIRGINIA - A medical doctor who operated two rural healthcare practices in Lebanon, Virginia was convicted today of federal drug and healthcare fraud charges. First Assistant United States Attorney Daniel P. Bubar and Virginia Attorney General Mark Herring made the announcement.
- August 1, 2018; New York Attorney General
- A.G. Underwood Announces Arrest Of Monroe County Nurse Aide For Alleged Patient Abuse
ROCHESTER - Attorney General Barbara D. Underwood announced the arrest and arraignment of Jerry Clarke, 57, of Rochester, a Certified Nurse Aide, for allegedly striking a nursing home patient. Clarke is charged with Endangering the Welfare of an Incompetent or Physically Disabled Person in the First Degree and Willful Violation of Health Laws, in the Town Justice Court of Gates in Monroe County.
July 2018
- July 24, 2018; Tennessee Department of Finance and Administration
- McMinn County Woman Charged 2nd Time with TennCare Drug Fraud
NASHVILLE, Tenn. - A McMinn County woman is charged for the second time with using TennCare to doctor shop for prescription drugs, using TennCare as payment.
- July 20, 2018; New York Attorney General
- A.G. Underwood And Comptroller DiNapoli Announce Jail Sentence For Queens Pharmacy Owner Who Stole Over $1.5 Million From Medicaid
NEW YORK - Attorney General Barbara D. Underwood and State Comptroller Thomas P. DiNapoli announced today the sentencing of Arkady Goldin, 40, of Brooklyn, owner of Value Pharmacy, Inc. ("Value"), a pharmacy formerly located in Queens before re-locating to its current location in Lynbrook, NY, for defrauding the New York State Medicaid program out of $1.5 million.
- July 20, 2018; Tennessee Department of Finance and Administration
- Gibson Co. Man Charged with TennCare Fraud
NASHVILLE, Tenn. - A Gibson County man is charged with TennCare fraud in connection with the sale of prescription drugs paid for by the state's healthcare insurance program.
- July 20, 2018; Tennessee Department of Finance and Administration
- White County Woman Charged with TennCare Fraud
NASHVILLE, Tenn. - A White County woman is charged with TennCare fraud for falsely reporting her income and failing to disclose her marriage in order to obtain TennCare benefits.
- July 18, 2018; Florida Attorney General
- Miami-Dade Man Arrested for Defrauding Medicaid
TALLAHASSEE, Fla.-Attorney General Pam Bondi's Medicaid Fraud Control Unit and the Miami-Dade Police Department today arrested a Miami man for defrauding the Medicaid program. According to the investigation, Armando Gonzalez, 57, worked as a targeted case manager at New Beginning Case Management Agency, LLC., located in the City of Hialeah. As a targeted case manager, Gonzalez assisted Medicaid recipients in gaining access to needed educational, medical, and social services--with the goal to optimize the functioning of patients with complex needs. Unfortunately, the defendant cataclysmically neglected to do preform these duties in the best interest of Medicaid recipients.
- July 16, 2018; Tennessee Department of Finance and Administration
- Four People Charged with TennCare Fraud
NASHVILLE, Tenn. - Four people are charged with TennCare fraud in separate cases out of upper east Tennessee. One of the suspects is facing his fifth round of TennCare fraud charges relating to using TennCare to unlawfully obtain prescription drugs.
- July 13, 2018; U.S. Attorney; Western District of Oklahoma
- Oklahoma Orthopedic Company and Physicians Agree to Pay $670,000 to Settle Allegations of False Claims to Medicare, Medicaid, and Tricare
OKLAHOMA CITY - SOUTHWEST ORTHOPAEDIC SPECIALISTS, PLLC; ANTHONY CRUSE, D.O.; R.J. LANGERMAN, JR., D.O.; DANIEL J. JONES, M.D.; MEHDI ADHAM, M.D.; DEREK WEST, D.O.; BRIAN LEVINGS, D.O.; SHANE HUME, D.O.; BRAD REDDICK, D.O.; and KRISTOPHER AVANT, D.O., have agreed to pay $670,000 to settle civil claims stemming from allegations that they submitted false claims to Medicare, Medicaid, and Tricare, announced Robert J. Troester, Acting United States Attorney for the Western District of Oklahoma, and Mike Hunter, Oklahoma Attorney General.
- July 9, 2018; Pennsylvania Attorney General
- CASE UPDATE: Nurse Charged in Death of Herbert R. McMaster, Sr. is Held for Trial following Preliminary Hearing
HARRISBURG - Attorney General Josh Shapiro announced that the nurse who failed to provide care for a patient at Cathedral Village in Upper Roxborough was held for trial today following her preliminary hearing. The patient, Herbert R. McMaster, Sr., 84, was left in the lobby of the facility and died 8 hours after suffering a fall and serious head injury.
- July 5, 2018; North Carolina Attorney General
- Attorney General Josh Stein Announces Nearly $10 Million Settlement with Rotech over Medicare and Medicaid False Claims
(RALEIGH) Attorney General Josh Stein announced today that North Carolina has settled with Rotech Healthcare Inc., a Florida-based respiratory equipment supplier, over civil allegations that Rotech knowingly submitted false claims for portable oxygen contents to Medicaid and Medicare. The settlement is joined by 22 other states and the federal government. The total settlement is $9.95 million, of which North Carolina will receive $43,671.23.
- July 3, 2018; U.S. Attorney; Eastern District of Virginia
- Medicaid Provider Agrees to Lifetime Exclusion from Medicaid
RICHMOND, Va. - The owner of several Richmond area medical support service companies has agreed to settle a civil fraud case alleging her companies defrauded the Virginia Medicaid program of over $1 million.
- July 3, 2018; Connecticut Attorney General
- Conn. Enters Joint State-Federal False Claims Act Settlement with Waterford Behavioral Health Provider
The state and federal governments have reached a joint settlement resolving allegations that a Waterford psychologist submitted false claims for behavioral health services she never provided to her Connecticut Medicaid patients, Attorney General George Jepsen and Connecticut Department of Social Services (DSS) Commissioner Roderick L. Bremby said today.
June 2018
- June 29, 2018; North Carolina Attorney General
- Attorney General Josh Stein Announces 2 Indictments in $4 Million Medicaid Fraud Scheme
(RALEIGH) Attorney General Josh Stein today announced that Catinia Farrington and Haydn Thomas of Durham were charged in federal district court with conspiracy to commit health care fraud, health care fraud, aggravated identity theft, and tax evasion. Thomas has also been charged with an additional charge of money laundering. The indictment alleges that Farrington and Thomas illegally used Medicaid numbers obtained from another provider to bill false claims to Medicaid.
- June 25, 2018; New York Attorney General
- A.G. Underwood Announces Sentencing Of Registered Nurse Who Stole Over $390,000 From Medicaid
WESTCHESTER - Attorney General Barbara D. Underwood today announced the sentencing of registered nurse Collins Anyanwu-Mueller, 48, of Seymour, Connecticut, for stealing over $390,000 from Medicaid. On November 2, 2017, Anyanwu-Mueller pleaded guilty to Grand Larceny in the Third Degree, a Class D felony, after an investigation conducted by the Attorney General's office revealed that, over the course of nearly five years, Anyanwu-Mueller submitted false claims for private duty nursing services that he never provided to severely disabled patients.
- June 18, 2018; Tennessee Department of Finance and Administration
- Obion County Man Charged with TennCare Drug Fraud
An Obion County man is charged in nearby Dyer County with TennCare fraud for passing forged prescriptions and using TennCare healthcare insurance benefits as payment.
- June 14, 2018; Tennessee Department of Finance and Administration
- Residents of Bedford, Lawrence Counties Charged with TennCare Drug Fraud
NASHVILLE, Tenn. - Residents of Bedford and Lawrence Counties are charged using TennCare benefits to doctor shop for drugs - and both have faced the charge multiple times in the past. Doctor shopping involves going to multiple doctors in a short period of time to obtain prescription drugs, using TennCare healthcare insurance benefits as payment.
- June 11, 2018; Nevada Attorney General
- Attorney General Laxalt Announces Sentencing of Home Health Worker
Las Vegas, NV - Nevada Attorney General Adam Paul Laxalt announced that David Benke, 45, of Las Vegas, was sentenced today in a Medicaid fraud case involving the failure to maintain adequate records to substantiate Medicaid claims.
- June 8, 2018; New York Attorney General
- A.G. Underwood And Comptroller DiNapoli Announce Guilty Plea Of Queens Pharmacy Owner For $1.5 Million Medicaid Fraud Scheme
QUEENS - Attorney General Barbara D. Underwood and State Comptroller Thomas P. DiNapoli announced today that Arkady Goldin, 40, of Brooklyn, and Value Pharmacy, Inc. ("Value") - a pharmacy formerly located in Corona, Queens before re-locating to its current location in Lynbrook, NY - entered felony guilty pleas in Supreme Court, Queens County admitting to defrauding the State's Medicaid program out of $1.5 million. The case was investigated and prosecuted as part of the Attorney General and State Comptroller's Joint Task Force on Public Integrity.
- June 6, 2018; Tennessee Department of Finance and Administration
- Cocke Co. Woman Charged 2nd Time with TennCare Fraud
NASHVILLE, Tenn. - A Cocke County woman is charged in nearby Hamblen County with doctor shopping for prescription drugs, using TennCare healthcare insurance benefits as payment.
- June 4, 2018; Tennessee Department of Finance and Administration
- Mississippi Woman Charged with TennCare Fraud
NASHVILLE, Tenn. - A Mississippi woman is charged with TennCare fraud for falsely reporting her residence in order to obtain benefits from TennCare, the state's taxpayer-funded healthcare insurance program.
- June 1, 2018; North Carolina Attorney General
- Attorney General Josh Stein Announces $325,000 Settlement over Medicaid Fraud
(RALEIGH) Attorney General Josh Stein announced today that the State of North Carolina has agreed to settle allegations against Atlanticare Home Care Agency involving the submission of fraudulent claims to the North Carolina Medicaid program. According to the allegations, Atlanticare, a Greenville company, allowed improperly qualified aides to serve patients and produced false documents in response to requests for verification. Atlanticare and its owner, Elbert Moore, will return $325,000 to the North Carolina Medicaid Program.
- June 1, 2018; North Carolina Attorney General
- Attorney General Josh Stein Announces $100,000 Settlement Over Medicaid Fraud
(RALEIGH) Attorney General Josh Stein announced today that the State of North Carolina has agreed to settle allegations against Brooke Stiles, D.D.S., over fraudulent Medicaid claims. Stiles allegedly billed for services that were not medically necessary, had no supporting clinical documentation, and/or were performed in violation of Medicaid policy. Stiles, who practiced in Kenansville, will repay $100,000 to the Medicaid program.
- June 1, 2018; North Carolina Attorney General
- Attorney General Josh Stein Announces Health Care Fraud and Aggravated Identity Theft Convictions
(RALEIGH) Attorney General Josh Stein announced today that Dr. Michael Alston Smith pled guilty to drug distribution, health care fraud, and aggravated identity theft in United States District Court in Charlotte. The conviction resolves allegations that Dr. Smith, a former Mount Holly family practice physician, illegally distributed controlled substances to female patients in exchange for sex acts.
- June 1, 2018; Tennessee Department of Finance and Administration
- Lawrence Co. Woman Charged with TennCare Fraud in Maury Co.
NASHVILLE, Tenn. - A Lawrence County woman is charged in Maury County with doctor shopping for prescription drugs, using TennCare as payment for the pills.
May 2018
- May 30, 2018; Texas Attorney General
- AG Paxton Reaches $15.2 Million Settlement with Fraudulent Medicaid Providers
Wednesday, May 30, 2018 - Austin
Attorney General Ken Paxton today announced $15.2 million in combined Medicaid fraud settlements with a group of Dallas-Fort Worth area Medicaid rehabilitation therapy providers. Six individuals and four companies agreed to settle claims they violated the Texas Medicaid Fraud Prevention Act. Several of the providers are permanently barred from participating as Texas Medicaid providers.
- May 30, 2018; Louisiana Attorney General
- Baton Rouge Woman Arrested for Kicking Patient in Her Care
BATON ROUGE, LA - Attorney General Jeff Landry today announced the arrest of a Baton Rouge woman accused of committing battery against her Medicaid patient, and he encouraged the public to report similar allegations of abuse to his Medicaid Fraud Control Unit (MFCU).
- May 29, 2018; Nevada Attorney General
- Attorney General Laxalt Announces Conviction of Medicaid Provider Business Ordered to pay over $1 Million in Restitution
Las Vegas, NV - Today, Nevada Attorney General Adam Paul Laxalt announced that We Care Behavioral Health Agency, LLC (We Care), based out of Las Vegas, was convicted for Medicaid fraud. The fraud was committed between April 2016 and August 2017.
- May 25, 2018; Kentucky Attorney General
- Beshear: Two Hazard Caregivers Indicted on Abuse Charges
HAZARD, Ky. (May 25, 2018) - Attorney General Andy Beshear and his Office of Medicaid Fraud and Abuse today announced the indictment of two Hazard caregivers on abuse charges.
- May 25, 2018; North Carolina Attorney General
- Attorney General Josh Stein Announces Health Care Fraud Conviction
(RALEIGH) Attorney General Josh Stein today announced that Carlos Brown was sentenced in federal district court in the Middle District of North Carolina for illegal healthcare kickbacks and was sentenced to five years of probation with one year of home detention. Carlos Brown was ordered to pay $393,000 in restitution to the North Carolina Medicaid Program.
- May 25, 2018; Pennsylvania Attorney General
- Cambria County Plastic Surgeon Pleads Guilty to $288K in Medicaid and Insurance Fraud
HARRISBURG - Attorney General Josh Shapiro announced that a Johnstown plastic surgeon who routinely billed Medicaid and private insurers for cancer treatments - even when the growths were not cancerous - pleaded guilty today to two felonies. The surgeon bilked private insurers and the Medicaid program out of $288,974 through this continuing scheme.
- May 23, 2018; U.S. Attorney; Eastern District of Tennessee
- Charles Turner and Donald Kevin Collins Sentenced for Mail Fraud Conspiracy to Defraud Mountain Empire Surgery Center
GREENEVILLE, Tenn. - On May 23, 2018, two individuals were sentenced by the Honorable J. Ronnie Greer, U.S. District Judge, for their roles in a conspiracy to commit mail fraud. Donald Kevin Collins, 41, of Elizabethton, Tennessee, was sentenced to serve 51 months in federal prison. Upon his release, he will be supervised by U.S. Probation for three years. He was also ordered to pay $1,381,552 in restitution. Charles Turner, 43, of Chattanooga, Tennessee, was sentenced to serve six months in prison, followed by six months home detention with electronic monitoring. Turner must also perform 150 hours of community service, be supervised by U.S. Probation for three years and pay $1,381,552 in restitution.
- May 17, 2018; Kansas Attorney General
- Emporia woman sentenced to 14 months in prison, ordered to repay $12,000 for Medicaid fraud
EMPORIA - (May 17, 2018) - An Emporia woman was sentenced yesterday to more than a year in prison and ordered to repay more than $12,000 to the Kansas Medicaid Program after pleading guilty to Medicaid fraud-related charges, Kansas Attorney General Derek Schmidt said.
- May 16, 2018; Kentucky Attorney General
- Couple allegedly submitted false billings to Medicaid for eye care services that were never provided
FRANKFORT, Ky. (May 16, 2018) - Today, Attorney General Andy Beshear and his Office of Medicaid Fraud and Abuse announced the indictment of an Eastern Kentucky eye center owner and his former wife on theft and Medicaid fraud charges.
- May 15, 2018; Arkansas Attorney General
- Rutledge Announces Pulaski County Woman Sentenced for Medicaid Fraud
LITTLE ROCK - Arkansas Attorney General Leslie Rutledge today announced the conviction of a Pulaski County woman on Medicaid fraud charges.
- May 9, 2018; Tennessee Department of Finance and Administration
- Shelby Co. Man Charged with TennCare Drug Fraud
NASHVILLE, Tenn. - A Shelby County man is charged with doctor shopping for prescription drugs, using TennCare as payment for the pills.
- May 1, 2018; Tennessee Department of Finance and Administration
- Lawrence Co. Woman Charged with TennCare Drug Fraud
NASHVILLE, Tenn. - A Lawrence County woman is charged in Giles County with doctor shopping for prescription drugs, using TennCare as payment for the pills.
April 2018
- April 30, 2018; Arkansas Attorney General
- Rutledge Announces Two Women Sentenced for Deception
LITTLE ROCK - Arkansas Attorney General Leslie Rutledge today announced the conviction of two women on unrelated charges.
- April 27, 2018; New Jersey Attorney General
- Attorney General's Office Charges Three More Individuals with Filing False Applications for Superstorm Sandy Relief Funds
TRENTON - Attorney General Gurbir S. Grewal today announced that the Attorney General's Office and its state and federal partners have charged three new defendants with filing fraudulent applications for federal relief funds related to Superstorm Sandy, bringing the total number of defendants charged by the office in these cases to 112 since March 2014.
- April 27, 2018; Tennessee Department of Finance and Administration
- Three People in Dyer County Charged with TennCare Fraud
NASHVILLE, Tenn. - Three people in Dyer County are charged with TennCare fraud in a joint police investigation.
- April 27, 2018; North Carolina Attorney General
- Attorney General Josh Stein Announces Nearly $500,000 Settlement Over Medicaid Fraud
(RALEIGH) Attorney General Josh Stein today announced a settlement with Dr. Carlos J. Privette, D.D.S., a dentist in Cary, over the submission of fraudulent claims to the North Carolina Medicaid program. Claims were submitted on Dr. Privette's behalf for inhalation of nitrous oxide, performance of full mouth debridements, performance of limited and complete oral evaluations, and the surgical removal of teeth from Medicaid recipients. It has been alleged that these services were not medically necessary and/or had no supporting clinical documentation. Dr. Privette will pay the North Carolina Medicaid Program $470,000 in restitution.
- April 27, 2018; Kentucky Attorney General
- Beshear: Medicaid Program to Receive $41,000 from Fraud Settlement Involving Genetic Testing
FRANKFORT, Ky. (April 27, 2018) - Attorney General Andy Beshear today announced a settlement of more than $41,000 as part of a Medicaid fraud case involving genetic testing services.
- April 26, 2018; Connecticut Attorney General
- State Files False Claims Act Lawsuit against East Hartford Behavioral Health Provider
The state has filed a lawsuit against an East Hartford-based licensed clinical social worker and her company alleging that they billed the state's Medicaid program for services that were not provided to Medicaid recipients, in violation of the Connecticut False Claims Act, Attorney General George Jepsen and state Department of Social Services (DSS) Commissioner Roderick L. Bremby said today.
- April 26, 2018; North Carolina Attorney General
- Attorney General Josh Stein Announces Nearly $1 Million Settlement with K-Mart over Medicaid Overbilling
(RALEIGH) Attorney General Josh Stein today announced a settlement with Kmart Corporation (K-Mart) over allegations that K-Mart charged the Medicaid program more than its usual and customary charge for certain drugs. K-Mart will pay North Carolina and the federal government $932,492.11.
- April 25, 2018; U.S. Attorney; Eastern District of New York
- Long Island Pediatrics Practice Agrees to Pay $750,000 to Settle False Claims Act Suit Alleging Improper Billing Practices
Long Island-based pediatrics practice Freed, Kleinberg, Nussbaum, Festa & Kronberg M.D., LLP, doing business as Pediatrics and Adolescent Medicine (the "Practice"), as well as current and former partner physicians of the Practice, including Arnold W. Scherz, M.D., Mitchell Kleinberg, M.D., Michael Nussbaum, M.D., Robert Festa, M.D., and Jason Kronberg, D.O. ("Partners"), have agreed to pay $750,000 to resolve allegations that they billed the Medicaid Program for services provided by physicians who were not enrolled in the program. The settlement, which resolved government claims under the federal False Claims Act and the New York State False Claims Act, was approved by United States District Judge Joanna Seybert.
- April 24, 2018; Alaska Department of Law
- The ARC of Anchorage to Pay Nearly $2.3 Million Dollars to Settle Medicaid False Claims Act Allegations
(Anchorage, Alaska) - The Alaska Department of Law announced today the Arc of Anchorage has agreed to resolve allegations the company violated the Federal False Claims Act by submitting false claims to the Alaska Medicaid Program and retaining Medicaid overpayment. Under the settlement agreement, The Arc of Anchorage has agreed to pay the Alaska Medicaid Program $2,299,392.16.
- April 16, 2018; North Carolina Attorney General
- Attorney General Stein Announces Nearly $10 Million Settlement Over Improper Billing for Portable Oxygen
(RALEIGH) Attorney General Josh Stein today announced that North Carolina will receive $43,671.23 as part of a $9.95 million settlement with Rotech Healthcare Inc., a Florida-based respiratory equipment supplier. This settlement comes in response to allegations that Rotech knowingly submitted false claims for portable oxygen contents to Medicaid and Medicare.
- April 11, 2018; Louisiana Attorney General
- Two Arrested on Medicaid Welfare Fraud Charges
BATON ROUGE, LA - Louisiana Attorney General Jeff Landry today announced the arrests of two people for Medicaid Welfare Fraud.
- April 11, 2018; Tennessee Department of Finance and Administration
- Maury Co. Woman Charged with TennCare Fraud in Maury, Williamson Counties
NASHVILLE, Tenn. - A Maury County woman is charged in both Maury and Williamson Counties with TennCare fraud involving doctor shopping, or using the state's healthcare insurance program to visit multiple doctors in a short time period seeking prescription drugs.
- April 6, 2018; Arkansas Attorney General
- Rutledge Announces Yell County Woman Sentenced for Healthcare Fraud
LITTLE ROCK - Arkansas Attorney General Leslie Rutledge today announced the conviction of a former Yell County Emergency Medical Services employee for theft of property and healthcare fraud. Donna Ward pleaded guilty in Conway County Circuit Court and must pay $250,000 in restitution, of which she has already paid $100,000. Ward was also sentenced to 20 years in the Arkansas Department of Correction with all but six months suspended, which will be spent in Arkansas Community Correction.
- April 6, 2018; Florida Attorney General
- Unlicensed Nurse Arrested for Defrauding Medicaid Out of More Than $715,000
TALLAHASSEE, Fla.-Attorney General Pam Bondi's Medicaid Fraud Control Unit and the Miramar Police Department today arrested an unlicensed nurse for defrauding the Medicaid program out of more than $715,000. According to the investigation, Lanre Saad Kelani, 61, practiced as a health care profession without a license for a Medicaid recipient with a serious disease that needed 24-hour home nursing care. Kelani used a sibling's name and license number to provide the services.
- April 4, 2018; U.S. Attorney; Western District of Oklahoma
- Oklahoma City Behavioral Health Counselor Pleads Guilty To Defrauding Medicaid
OKLAHOMA CITY - SAMUEL OKERE, 61, of Oklahoma City, has pleaded guilty to Medicaid fraud, announced Robert J. Troester, Acting United States Attorney for the Western District of Oklahoma, and Mike Hunter, Oklahoma Attorney General.
- April 3, 2018; Tennessee Department of Finance and Administration
- Tipton Co. Woman Charged 2nd Time with TennCare Drug Fraud
NASHVILLE, Tenn. - A Tipton County woman is charged with doctor shopping for prescription drugs, using TennCare as payment. It's her second round of TennCare fraud charges this year.
- April 3, 2018; Tennessee Department of Finance and Administration
- McMinn County Woman Charged with TennCare Drug Fraud
NASHVILLE, Tenn. - A McMinn County woman is charged with TennCare fraud in connection with selling prescription drugs she obtained through the state's healthcare insurance program.
March 2018
- March 30, 2018; New York Attorney General
- A.G. Schneiderman Announces Arrest Of Binghamton Transport Owner Charged With Stealing Over $100K From Medicaid
BINGHAMTON - Attorney General Eric T. Schneiderman announced the arrest of Garabed Kachadourian of Broome County for allegedly stealing over $100,000 in Medicaid payments by knowingly operating a transportation company without Workers' Compensation Insurance or a valid taxi business license, and falsely filing documents stating the company was in compliance. Kachadourian owned and operated BC Cab, Inc., a transportation company operating in Broome County, which received payments from the Medicaid program for transporting Medicaid beneficiaries to medical appointments.
- March 28, 2018; Massachusetts Attorney General
- Husband and Wife Charged With Fraudulently Billing Masshealth for Services for Patient Who Died
Boston - A Dorchester husband and wife have been charged with allegedly defrauding the state's Medicaid program, known as MassHealth, by falsely billing for services not rendered for a patient during her hospitalization and after she was deceased, Attorney General Maura Healey announced today.
- March 28, 2018; New York Attorney General
- A.G. Schneiderman Announces $10.3 Million Joint State-Federal Settlement With CenterLight Over False Medicaid Billing
NEW YORK - Attorney General Eric T. Schneiderman announced today a joint state-federal settlement with CenterLight Health System, Inc. and CenterLight Healthcare, Inc. (together, "CenterLight") over false Medicaid billing. CenterLight will pay $10.36 million to settle state and federal allegations that its former managed long-term care plan ("CenterLight MLTCP") submitted fraudulent requests to New York's Medicaid program for monthly premiums and failed to repay Medicaid for falsely-obtained payments, violating New York and federal False Claims Acts. New York's Medicaid program will receive $6.36 million in restitution and penalties from the total settlement payment.
- March 28, 2018; Tennessee Department of Finance and Administration
- Cumberland Co. Man Charged with TennCare Drug Fraud
NASHVILLE, Tenn. - A Cumberland County man is charged with TennCare fraud in connection with selling prescription drugs he obtained using TennCare healthcare insurance benefits.
- March 27, 2018; Florida Attorney General
- Two Healthcare Operators Sentenced to Prison and Ordered to Pay More Than $1.3 Million in Restitution
TALLAHASSEE, Fla.--Attorney General Pam Bondi's Medicaid Fraud Control Unit, the U.S. Department of Health and Human Services and United States Attorney's Office today announced the sentencing of two medical care providers. Shawn Tharpe, 30, and Ruben McLain, 46, both of Winston Salem, NC, have been sentenced to federal prison for participation in a conspiracy to commit healthcare fraud.
- March 26, 2018; Florida Attorney General
- Florida Man Sentenced to 12 Years for Exploiting Blind Elderly Man of More Than $20,000
TALLAHASSEE, Fla.--Attorney General Pam Bondi today announced that the Honorable Judge Gary Bergosh, Escambia Circuit Court, sentenced John Louis Wages, 46, to 12 years in state prison. Wages is responsible for one count of exploitation and one count of fraudulent use of personal identification information of a person 60 years of age or older.
- March 23, 2018; New York Attorney General
- A.G. Schneiderman Announces State Prison Sentence For Long Island Man Convicted Of Stealing From Medicaid Funded Charity
OYSTER BAY-Attorney General Eric T. Schneiderman today announced a state prison sentence of 2 to 6 years for John Cornachio, 63, of Oyster Bay, NY. Cornachio was convicted after trial of Grand Larceny in the Second Degree, a class C felony, for using a "no-show" job to steal from Narco Freedom Inc., a former Medicaid-funded, not-for-profit corporation based in the Bronx that was founded to provide substance abuse services throughout New York City. In addition to being sentenced to time in jail, Cornachio was ordered to pay $840,000 in restitution to the New York State Medicaid Fraud Restitution Fund.
- March 22, 2018; Kentucky Attorney General
- Beshear: Mom, Caretaker Pleaded Guilty to Defrauding Medicaid
FRANKFORT, Ky. (March 22, 2018) - Attorney General Andy Beshear and his Office of Medicaid Fraud and Abuse today announced the guilty pleas of a London mom and a caretaker who defrauded Kentucky's Medicaid program out of thousands of dollars meant to fund care for the mom's son.
- March 22, 2018; North Carolina Attorney General
- Attorney General Josh Stein Announces Sentencing in Health Care Fraud Conspiracy
(RALEIGH) Attorney General Josh Stein announced today that Christopher Leon Brown and Mark Rayfield Brown, Jr., both of Raleigh, have been sentenced to 40 months in prison and 30 months in prison, respectively, for health care fraud conspiracy. Together with Darryl Stanford, another co-conspirator who has pleaded guilty, the defendants are to pay $755,225 in restitution. Mark Brown is liable for $455,480 of the total restitution.
- March 20, 2018; Connecticut Attorney General
- Thomaston Woman Sent to Prison for Medicaid Fraud
A Thomaston woman will serve more than five years in prison for using a relative’s name to bill Medicaid for more than $600,000 in services she was not legally qualified to provide or did not provide at all.
- March 21, 2018; U.S. Attorney; Eastern District of North Carolina
- Raleigh Residents Sentenced for Health Care Fraud Conspiracy Targeting North Carolina Medicaid
RALEIGH - Robert J. Higdon, Jr., the United States Attorney for the Eastern District of North Carolina, announces that yesterday in Federal court in New Bern, United States District Judge Louise W. Flanagan sentenced CHRISTOPHER LEON BROWN and MARK RAYFIELD BROWN, JR., both of Raleigh, North Carolina to 40 months in prison and 30 months in prison, respectively, for their roles in a health care fraud conspiracy that targeted the North Carolina Medicaid system. The Court ordered the terms of imprisonment to be followed by three years of supervised release. Both defendants were also ordered to pay restitution to the North Carolina Medicaid Program, among other terms of the judgment.
- March 19, 2018; U.S. Attorney; Western District of Virginia
- Coeburn Doctor Sentenced on Healthcare Fraud, Drug Charges
Abingdon, VIRGINIA - A Coeburn physician, who prescribed Ritalin and hydrocodone to an undercover investigator, will serve two years' probation, pay a $25,000 fine, surrender his medical license and pay $945,000 in restitution and forfeiture, announced United States Attorney Rick A. Mountcastle and Virginia Attorney General Mark Herring.
- March 16, 2018; North Carolina Department of Justice
- Attorney General Josh Stein Announces Sentencing in Fayetteville Medicaid Fraud Case
(RALEIGH) Attorney General Josh Stein announced today that Barbara McDuffie pled guilty to felony Medicaid fraud in Cumberland County Superior Court. The conviction resolves allegations that McDuffie submitted falsified timesheets and medical service notes to the Autism Society of North Carolina for 1,359 hours of medical services she did not provide. McDuffie, who worked in Fayetteville, provided personal care services and in-home skill building services to Medicaid recipients while working for the Autism Society of North Carolina.
- March 15, 2018; Nevada Attorney General
- Attorney General Laxalt Announces Sentencing of Reno Behavioral Health Company Owner
Carson City, NV - Today, Nevada Attorney General Adam Paul Laxalt announced that Jeanice Rae Moore, 54, of Reno, was sentenced in a Medicaid fraud case involving her submission of false claims to Nevada Medicaid. The fraud was committed between June 2015 and January 2016.
- March 9, 2018; South Dakota Attorney General
- State Reaches Civil Settlement with Black Hills Psychology in Medicaid Case
PIERRE, S.D.- Attorney General Marty Jackley announced today that South Dakota has reached a civil Settlement Agreement and an Integrity Agreement with Black Hills Psychology of Spearfish, SD, in a case involving Medicaid payments.
- March 9, 2018; Kentucky Attorney General
- Beshear: Louisa Couple Sentenced on Multiple Felony Counts of Medicaid Fraud
FRANKFORT, Ky. (March 9, 2018) - Attorney General Andy Beshear and his Office of Medicaid Fraud and Abuse today announced a Lawrence County couple has been sentenced on multiple felony counts of Medicaid fraud.
- March 7, 2018; New York Attorney General
- A.G. Schneiderman Announces $750,000 Joint Settlement With Long Island Pediatrics Practice Resolving Allegations Company Submitted False Claims To Medicaid
HOLBROOK, NY-Attorney General Eric T. Schneiderman today announced a joint state-federal settlement with the Long Island, NY-based pediatrics practice Freed, Kleinberg, Nussbaum, Festa & Kronberg M.D., LLP (Practice), as well as various current and former partner physicians of the Practice, including Arnold W. Scherz, M.D., Mitchell Kleinberg, M.D., Michael Nussbaum, M.D., Robert Festa, M.D., and Jason Kronberg, D.O. (Partners)-doing business as Pediatrics and Adolescent Medicine. The agreement settles allegations that the Practice and Partners did not routinely enroll all of their employee providers treating Medicaid patients in the Medicaid program, and instead used the Partners' Medicaid provider identification numbers to bill for the treatment of Medicaid beneficiaries by unenrolled employee providers. An investigation conducted by the Attorney General's office found that the false claims occurred at many of the practice's Long Island locations. The pediatrics practice has locations in Holbrook, Port Jefferson, Shirley, and Wading River, NY. New York's Medicaid program will receive $450,000 as part of the $750,000 settlement agreement.
- March 6, 2018; Nevada Attorney General
- Attorney General Laxalt Announces Conviction of Medicaid Provider Business
Las Vegas, NV - Nevada Attorney General Adam Paul Laxalt announced that Because We Care, LLC (hereinafter BWC), based out of Las Vegas, was convicted today for Medicaid fraud.
- March 1, 2018; Arkansas Attorney General
- Rutledge Announces Arrest of Northwest Arkansas Woman for Medicaid Fraud
LITTLE ROCK - Arkansas Attorney General Leslie Rutledge today announced the arrest of a Springdale woman.
February 2018
- February 27, 2018; Nevada Attorney General
- Attorney General Laxalt Announces Sentencing of Medicaid Provider
Las Vegas, NV - Nevada Attorney General Adam Paul Laxalt announced that John Harris, 34, of Las Vegas, was sentenced today in a Medicaid fraud case involving the failure to maintain proper documentation for services provided to Medicaid recipients.
- February 20, 2018; Tennessee Department of Finance and Administration
- Tipton Co. Woman Charged with TennCare Drug Fraud
NASHVILLE, Tenn. - A Tipton County woman is charged in nearby Shelby County with doctor shopping for prescription drugs, using TennCare healthcare insurance benefits as payment for the pills.
- February 20, 2018; Tennessee Department of Finance and Administration
- Blount Co. Woman to Repay TennCare
NASHVILLE, Tenn. - A Blount County woman has been ordered to repay the state after facing charges of fraudulently obtaining TennCare healthcare insurance benefits.
- February 16, 2018; New York Attorney General
- A.G. Schneiderman Announces Trial Conviction Of Long Island Man For Stealing From Bronx Medicaid-Funded Charity
BRONX - Attorney General Eric T. Schneiderman today announced that a Bronx County jury found John Cornachio, 63, of Oyster Bay, NY, guilty of Grand Larceny in the Second Degree, a class C felony, for holding "no-show" job in order to steal from Narco Freedom Inc., a former Bronx-based, Medicaid-funded, not-for-profit corporation that was founded to provide substance abuse services throughout New York City. Cornachio faces up to 15 years in state prison when he is sentenced on March 2, 2018. Cornachio was remanded to jail pending sentencing.
- February 18, 2018; Louisiana Attorney General
- Three Arrested for Medicaid Welfare Fraud
BATON ROUGE, LA - Louisiana Attorney General Jeff Landry today announced the arrests of three people on multiple counts of Medicaid Fraud, and he encouraged the public to report welfare fraud to his office.
- February 15, 2018; New Jersey Department of Law & Public Safety
- Pennsylvania Woman Charged with Stealing Nearly $78,000 from Elderly Relative with Dementia Living in Long-Term Care Facility
TRENTON - Attorney General Gurbir S. Grewal and the Office of Insurance Fraud Prosecutor today announced that a Pennsylvania woman has been charged with stealing nearly $78,000 from an elderly relative who suffers from dementia and resides in a long-term care facility in Warren County, New Jersey.
- February 12, 2018; Tennessee Department of Finance and Administration
- Hamblen Co. Woman Charged with TennCare Fraud
NASHVILLE, Tenn. - A Hamblen County woman is charged with TennCare fraud for falsely reporting that she resided in Tennessee in order to obtain benefits from the taxpayer-funded program.
- February 12, 2018; Tennessee Department of Finance and Administration
- Sumner County Woman Charged with TennCare Fraud
NASHVILLE, Tenn. - A Sumner County woman is charged in both Sumner and Davidson Counties with TennCare fraud involving doctor shopping, or using TennCare to go to multiple doctors in a short time period to obtain prescriptions for controlled substances.
- February 8, 2018; Massachusetts Attorney General
- Mental Health Center to Pay $4 Million under AG Settlement for Illegally Billing MassHealth for Unlicensed Patient Care
Boston - Attorney General Maura Healey announced today that South Bay Mental Health Center, Inc. (SBMHC) has agreed to pay $4 million based on allegations that it fraudulently billed the state’s Medicaid Program, known as MassHealth, for mental health care services provided to patients by unlicensed, unqualified, and unsupervised staff members at clinics across the state.
- February 8, 2018; Tennessee Department of Finance and Administration
- McMinn County Woman Charged with TennCare Drug Fraud
NASHVILLE, Tenn. - A McMinn County woman is charged in nearby Bradley County with doctor shopping for prescription drugs, using TennCare healthcare insurance benefits as payment.
- February 8, 2018; Tennessee Department of Finance and Administration
- Shelby Co. Woman Charged with TennCare Fraud
NASHVILLE, Tenn. - A Shelby County woman is charged with doctor shopping for prescription drugs, using TennCare healthcare insurance benefits as payment.
- February 7, 2018; Florida Attorney General
- Florida State Hospital Employee Arrested for Abusing a Disabled Person
TALLAHASSEE, Fla.- Attorney General Pam Bondi's Medicaid Fraud Control Unit and the Baker County Sheriff's Office today arrested a former Northeast Florida State Hospital employee for abusing a disabled adult. Antrisa Fontae Butler, 27, a human services worker allegedly struck a schizophrenic resident multiple times in the head and neck.
- February 6, 2018; New Jersey Department of Law & Public Safety
- Certified Nurse Aide, Three Others Charged with Stealing More than $80,000 from Two Elderly, Disabled Individuals
TRENTON - Attorney General Gurbir S. Grewal and the Office of Insurance Fraud Prosecutor (OIFP) today announced that four individuals have been charged with financially exploiting elderly, disabled individuals - including a Certified Nurse Aide accused of cashing more than $30,000 in forged checks taken from a patient he was caring for at a Jersey City rehabilitation center.
- February 6, 2018; Tennessee Department of Finance and Administration
- Maury Co. Woman Charged with TennCare Drug Fraud
NASHVILLE, Tenn. - A Maury County woman is charged with TennCare fraud in Williamson and Coffee Counties, and it's her second round of charges in Williamson County.
- February 5, 2018; Louisiana Attorney General
- Two Louisiana Women Arrested for Medicaid Fraud
BATON ROUGE, LA - Attorney General Jeff Landry today announced that two women have been arrested by his award-winning Medicaid Fraud Control Unit.
- February 2, 2018; Tennessee Department of Finance and Administration
- Maury Co. Woman Charged with TennCare Drug Fraud
NASHVILLE, Tenn. - A Maury County woman is charged in nearby Williamson County with doctor shopping for prescription drugs, using TennCare healthcare insurance benefits as payment for the pills.
- February 1, 2017; Florida Attorney General
- Pensacola Resident Arrested for Exploiting the Elderly to Fund Vacations
TALLAHASSEE, Fla.-Attorney General Pam Bondi's Medicaid Fraud Control Unit and the Escambia County Sheriff's Office today arrested a Pensacola man for exploiting an elderly victim and using funds for vacations to Baton Rouge, La. and Las Vegas, Nev. Steven McAroy, 44, acted in a position of trust for the victim and signed all financial documents while the victim resided in a long-term care facility.
January 2018
- January 31, 2018; Pennsylvania Attorney General
- Bucks County Dentist Charged with $1.5 Million in Fraudulent Bills to Pennsylvania Medicaid Program
HARRISBURG - Attorney General Josh Shapiro today announced felony charges against a Bucks County dentist after he and his company submitted $1.5 million in fraudulent claims to the Medical Assistance Program for dental work that was never performed.
- January 25, 2018; New Jersey Department of Law and Public Safety
- Owner of Hudson County Medical Equipment Supply Store Sentenced to Prison for Stealing $100,000 through Medicaid Fraud Scam
TRENTON -Attorney General Gurbir S. Grewal and the Office of the Insurance Fraud Prosecutor (OIFP) announced that the owner of a Hudson County medical equipment supply store was sentenced today to prison for fraudulently billing the Medicaid program more than $100,000 for medical supplies never provided to patients.
- January 23, 2018; Florida Attorney General
- Pensacola Resident Convicted of Exploitation of the Elderly
TALLAHASSEE, Fla.-Attorney General Pam Bondi today announced the conviction of a Pensacola man for exploiting and fraudulently using the personal identification information of a legally blind elderly victim. After deliberating for nine hours, the jury found John Louis Wages, 45, guilty as charged on both counts.
- January 17, 2018; North Carolina Attorney General
- Attorney General Josh Stein Announces Settlement with Raleigh Dentist over Medicaid Claims
(RALEIGH) Attorney General Josh Stein today announced a settlement with Javeria Nasir, a dentist in Raleigh. Dr. Nasir allegedly submitted fraudulent claims to the North Carolina Medicaid program. Allegedly, Dr. Nasir submitted claims between Jan. 1, 2015 and July 31, 2017, for "extended care facility calls" and "full mouth debridements" that were not medically necessary, had no supporting clinical documentation, and were performed in violation of Medicaid policy.
- January 16, 2018; South Carolina Attorney General
- Carr: All-In Effort Leads to Dismantling of Systematic Elder Abuse Scheme
ATLANTA, GA - Attorney General Chris Carr, in conjunction with the Georgia Bureau of Investigation (GBI), the Prosecuting Attorneys Council of Georgia (PACGA), the Dougherty County District Attorney (DA), and various local law enforcement and first responding entities in the cities of Albany, Forsyth, Macon and Suwanee, today announced that their collaborative efforts led to the dismantling of a systematic elder abuse scheme coordinated by three individuals.
- January 16, 2018; New York Attorney General
- A.G. Schneiderman Announces Indictment And Arrests Of Medical Testing Company Owners In Multi-Million Dollar Medicaid Fraud
BROOKLYN - Attorney General Eric T. Schneiderman today announced the indictment and arrest of Tea Kaganovich, 45, and Ramazi Mitiashvili, 57, both of Brooklyn, NY for Grand Larceny in the First Degree and other related charges for illegally billing Medicaid for fraudulent diagnostic testing services and laundering the criminal proceeds from their scheme. The Attorney General also filed a civil lawsuit seeking $24 million in damages from the defendants under the State's False Claims Act and other laws. The indictment alleges that Kaganovich and Mitiashvili, operators of Sophisticated Imaging, Inc., East Coast Diagnostics, Inc., and East West Management, Inc., engaged in a systematic scheme to subject Medicaid patients to a battery of diagnostic tests that were not medically necessary and not ordered by real physicians.
- January 12, 2018; New York Attorney General
- A.G. Schneiderman Announces Settlement With Whitney M. Young Health Center For Improperly Billing Medicaid For Substandard Substance Abuse Services
ALBANY - New York Attorney General Eric T. Schneiderman today announced a $1.25 million settlement with the Whitney M. Young Health Center for improper billing by its Methadone Maintenance Treatment Program, which failed to properly document patient treatment plans necessary for the patients' care.
- January 12, 2018; Florida Attorney General
- Dentist and Office Manager Arrested for More Than $50,000 in Medicaid Fraud
TALLAHASSEE, Fla.-Attorney General Pam Bondi's Medicaid Fraud Control Unit and the Pembroke Pines Police Department today arrested a dentist and office manager for defrauding the Medicaid program out of more than $50,000. According to the MFCU investigation, Maritza Lazcano, owner of Lazcano Family Dental, and Luis Garcia Fragoso, the office manager, fraudulently billed the Medicaid program for numerous dental procedures never performed. These procedures included cleanings, crowns, root canals, x-rays, etc.
- January 11, 2018; Tennessee Department of Finance and Administration
- Knox Co. Woman Charged with TennCare Fraud
NASHVILLE, Tenn. - A Knox County woman is charged with doctor shopping for prescription drugs, using TennCare healthcare insurance benefits as payment for the pills. Doctor shopping involves visiting multiple doctors in a 30-day period in order to obtain prescriptions for drugs, usually narcotics and other controlled substances.
- January 10, 2018; Tennessee Department of Finance and Administration
- Hawkins Co. Man Charged 3rd Time with TennCare Fraud
NASHVILLE, Tenn. - A Hawkins County man is charged for the third time with doctor shopping for controlled substances, using TennCare as payment. All the cases involve efforts to obtain prescriptions for opioids.
- January 11, 2018; U.S. Department of Justice
- Michigan Clinic Office Manager Pleads Guilty to $131 Million Health Care Fraud Scheme Involving Unnecessary Prescription of Controlled Substances
A Michigan clinic office manager pleaded guilty today for his role in a health care fraud scheme that involved the unnecessary prescription of controlled substances and that resulted in a $131 million loss to Medicare.
- January 11, 2018; Tennessee Department of Finance and Administration
- Knox Co. Woman Charged with TennCare Fraud
NASHVILLE, Tenn. - A Knox County woman is charged with doctor shopping for prescription drugs, using TennCare healthcare insurance benefits as payment for the pills. Doctor shopping involves visiting multiple doctors in a 30-day period in order to obtain prescriptions for drugs, usually narcotics and other controlled substances.
- January 10, 2018; Tennessee Department of Finance and Administration
- Hawkins Co. Man Charged 3rd Time with TennCare Fraud
NASHVILLE, Tenn. - A Hawkins County man is charged for the third time with doctor shopping for controlled substances, using TennCare as payment. All the cases involve efforts to obtain prescriptions for opioids.
- January 9, 2018; Massachusetts Attorney General
- AG Healey Sues Mental Health Center for Illegally Billing MassHealth for Unlicensed and Unsupervised Patient Care
Boston - Attorney General Maura Healey has sued South Bay Mental Health Center, Inc. (SBMHC) for fraudulently billing the state's Medicaid Program, known as MassHealth, for mental health care services provided to patients by unlicensed, unqualified, and unsupervised staff members at clinics across the state.
- January 4, 2018; Florida Attorney General
- Fort Lauderdale Dentist Arrested for Violation of Probation
TALLAHASSEE, Fla.-Attorney General Pam Bondi's Medicaid Fraud Control Unit and the Broward County Sheriff's Office arrested a Fort Lauderdale dentist for violation of probation. Dr. Marino Vigna is currently serving probation following an MFCU investigation and arrest in 2016 for allegedly billing Medicaid for services not rendered. Dr. Vigna pleaded Nolo Contendere to a charge of grand theft, a third-degree felony.
December 2017
- December 29, 2017; Illinois Attorney General
- MADIGAN: CHICAGO WOMAN CHARGED FOR DEFRAUDING STATE OUT OF APPROXIMATELY $100,000 IN MEDICAID FUNDING
Chicago - Attorney General Lisa Madigan announced that a Chicago doctor was charged with Medicaid fraud for defrauding the state out of approximately $100,000 in Medicaid funding.
- December 29, 2017; U.S. Attorney; Northern District of Indiana
- Medicaid Fraud Complaint Filed Against Former Physicians And Their Business Entities
HAMMOND - United States Attorney Thomas L. Kirsch II and Indiana Attorney General Curtis T. Hill, Jr. announced today the filing of a civil Medicaid fraud complaint against former physicians Don J. Wagoner, age 81, of Burlington, Indiana and Marilyn L. Wagoner, age 80, of Burlington, Indiana, and their business entities, Wagoner Medical Center, L.L.C., Wagoner Medical Center, P.C., and Don J. Wagoner, M.D. and Marilyn L. Wagoner, M.D., P.C. for filing false claims.
- December 28, 2017; South Dakota Attorney General
- Sioux Falls Man Sentenced in Medicaid Fraud Case
PIERRE, S.D. - Attorney General Marty Jackley announced today that Steven P. Haddorff, 64, Sioux Falls, was sentenced for a Medicaid Fraud offense.
- December 21, 2017; Florida Attorney General
- CNA Arrested for Neglecting an Elderly Person
TALLAHASSEE, Fla.-Attorney General Pam Bondi's Medicaid Fraud Control Unit and the Jacksonville Sheriff's Office today arrested Nekeysha Cromwell, 32, a certified nursing assistant at San Jose Health and Rehabilitation Center, for neglecting an elderly resident of the facility. According to the MFCU investigation, after Cromwell ignored nurse instructions and facility protocols the victim fractured both femurs.
- December 20, 2017; New York Attorney General
- A.G. Schneiderman Announces Arrests In Alleged Cover Up Of White Plains Nursing Home Neglect
WHITE PLAINS - Attorney General Eric T. Schneiderman announced the arrest today of Certified Nurse Aides (CNAs) Janet Rose, 62, of Mt. Vernon, and Verlanda Paulma, 25, of White Plains, for Endangering the Welfare of an Incompetent or Physically Disabled Person in the First Degree and additional related charges. Both Rose and Paulma, who were employed as CNAs at the White Plains Center for Nursing Care (White Plains Center), allegedly failed on May 26, 2017 to perform monitoring checks of an at-risk resident with dementia who eloped and wandered from the facility.
- December 19, 2017; Tennessee Department of Finance and Administration
- Wilson Co. Woman Charged 2nd Time with TennCare Fraud
NASHVILLE, Tenn. - A Wilson County woman is charged for the second time with doctor shopping for prescription drugs, using TennCare as payment.
- December 19, 2017; Florida Attorney General
- Hillsborough County Woman Arrested for Medicaid Provider Fraud
TALLAHASSEE, Fla.-Attorney General Pam Bondi's Medicaid Fraud Control Unit today announced the arrest of a Hillsborough County woman for defrauding the Medicaid program out of at least $5,000. While working for My Harvest, a Medicaid provider of companion services, Geraldine Rivera, 32, allegedly caused her employer to bill for services never provided. According to the MFCU investigation, Rivera, continued to report providing companion services to a disabled Medicaid recipient long after Rivera stopped servicing the recipient. My Harvest no longer employs Rivera.
- December 18, 2017; U.S. Attorney; Western District of Oklahoma
- Owners of Oklahoma City Diabetic Supply Company Charged with Medicaid Fraud
Oklahoma City, Oklahoma - A federal grand jury has charged EUNJA VASQUEZ, 55, and LAWRENCE VASQUEZ, 61, of Edmond, Oklahoma, with Medicaid fraud, announced Mark A. Yancey, U.S. Attorney for the Western District of Oklahoma, and Mike Hunter, Oklahoma Attorney General.
- December 18, 2017; Florida Attorney General
- Hillsborough County Woman Arrested for Medicaid Provider Fraud
TALLAHASSEE, Fla.-Attorney General Pam Bondi's Medicaid Fraud Control Unit today announced the arrest of a Hillsborough County woman for defrauding the Medicaid program out of at least $5,000. While working for My Harvest, a Medicaid provider of companion services, Geraldine Rivera, 32, allegedly caused her employer to bill for services never provided. According to the MFCU investigation, Rivera, continued to report providing companion services to a disabled Medicaid recipient long after Rivera stopped servicing the recipient. My Harvest no longer employs Rivera.
- December 15, 2017; New Jersey Attorney General
- New Jersey Dentist Sentenced to Eight Year Prison Term, Ordered to Pay $7 Million in Scheme to Defraud Medicaid
TRENTON - Attorney General Christopher S. Porrino and the Office of the Insurance Fraud Prosecutor announced that the owner of a now-defunct Central Jersey mobile dental practice today was sentenced to eight years in prison and ordered to pay $7 million in restitution and civil penalties in connection with a scheme to defraud more than $5.5 million from Medicaid.
- December 13, 2017; North Carolina Attorney General
- Attorney General Josh Stein Announces Sentencing in Fayetteville/Raeford Medicaid Fraud Case
(RALEIGH) Attorney General Josh Stein announced today that Dr. Jannetta Jordan pled guilty to four felonies in Wake County Superior Court for Medicaid fraud. Dr. Jordan was convicted of Felony Fraud by a Medical Assistance Provider, Felony Accessing a Government Computer to Defraud and two counts of Felony Obstruction of Justice. Dr. Jordan, who has already served two years in jail, was sentenced to 34 to 80 months in prison, suspended for 36 months of supervised probation. The court ordered Dr. Jordan to pay restitution of $897,942.33 as a civil judgment and was ordered to complete 250 hours of community service.
- December 12, 2017; Missouri Attorney General
- AG Hawley Announces Former Nursing Home Employee Sentenced to 17 Years for Financial Abuse of Medicaid Recipient and Receiving Stolen Property
Jefferson City, Mo. - Missouri Attorney General Josh Hawley announced that Kristi Metcalf, 41, of Carthage, Missouri, has been sentenced to 10 years for receiving stolen property and seven years for financial abuse of a Medicaid patient, to be served concurrently for ten years. She must also pay $44,561 in restitution to her victims and $15,370.63 for the State's prosecution costs. In October, Metcalf pled guilty to the class B felony of receiving stolen property and the class C felony of abuse of a health care recipient in the Circuit Court of Jasper County.
- December 8, 2017; Florida Attorney General
- Caregiver Arrested for Defrauding Medicaid Out of More Than $85,000
TALLAHASSEE, Fla.-Attorney General Pam Bondi's Medicaid Fraud Control Unit and the Martin County Sheriff's Office announced the arrest of a home and community based caregiver for defrauding the Medicaid program out of more than $85,000. According to the MFCU investigation, Luther Jerome Robinson, 50, fraudulently submitted billing records and progress notes for services never provided to several Medicaid recipients.
- December 8, 2017; Connecticut Attorney General
- State-Federal Settlement Reached with Opioid Treatment Provider to Resolve Medicaid Overpayment Claim Allegations
Hartford - A Connecticut healthcare organization and its chief executive officer have reached an $883,859 settlement with the state of Connecticut and the federal government to resolve allegations that the company submitted improper claims for payment to Connecticut's Medicaid program, Attorney General George Jepsen and state Department of Social Services (DSS) Commissioner Roderick L. Bremby said today.
- December 6, 2017; Florida Attorney General
- UPDATE: Alachua County Woman Sentenced for Grand Theft and Organized Fraud
TALLAHASSEE, Fla.-Attorney General Pam Bondi's Medicaid Fraud Control Unit announced the sentencing of Janet E. Williams, 51, from Alachua County, for grand theft and organized fraud. On Dec. 4, 2017, pursuant to a plea agreement, the Honorable Mark Moseley, Circuit Judge for the Eighth Judicial Circuit sentenced Williams to 30 days in jail and five years of probation. In addition to standard fines and court costs, Williams is also ordered to pay more than $8,000 in restitution.
- December 5, 2017; Massachusetts Attorney General
- AG Secures More Than $14 Million From Home Health Agency
Boston - As part of an effort in Massachusetts to address fraud, waste and abuse in the home health industry, Attorney General Maura Healey announced today that a national home health agency has agreed to pay more than $14 million to settle allegations that it improperly submitted and received overpayments for services from the state's Medicaid program, known as MassHealth.
November 2017
- November 30, 2017; Tennessee Department of Finance and Administration
- Blount Co. Man Charged with TennCare Fraud
NASHVILLE, Tenn. - A Blount County man has been charged in nearby Knox County with TennCare fraud for filling a forged prescription and using TennCare healthcare insurance benefits as payment.
- November 30, 2017; New York Attorney General
- A.G. Schneiderman Announces Guilty Plea And Conviction Of Private-Duty Nurse Who Stole Over $27,000 From Medicaid
HAMBURG - Attorney General Eric T. Schneiderman today announced the guilty plea of Licensed Practical Nurse Liane P. Tomlinson, 33, of Hamburg, New York, for stealing over $27,000 from Medicaid. An investigation conducted by the Attorney General's Office revealed that over the course of 17 months, Tomlinson submitted false claims for private-duty nursing services that she never provided to six disabled children.
- November 21, 2017; Tennessee Department of Finance and Administration
- Meigs Co. Woman Charged 5th Time with TennCare Fraud
NASHVILLE, Tenn. - A Meigs County woman is now facing her fifth round of TennCare fraud charges.
- November 21, 2017; Tennessee Department of Finance and Administration
- Kentucky Woman Charged with TennCare Fraud
NASHVILLE, Tenn. - A Kentucky woman is charged with TennCare fraud in an indictment accusing her of lying about her residency in order to obtain TennCare healthcare insurance benefits.
- November 21, 2017; Arkansas Attorney General
- Rutledge Announces Benton Woman Sentenced for Exploiting Impaired Adults
LITTLE ROCK - Arkansas Attorney General Leslie Rutledge today announced the conviction of a Benton woman for transferring funds out of nursing home residents' trust accounts. Beverly Ann Brooks pleaded guilty in Pulaski County Circuit Court and was sentenced to one year probation and must pay $1,540.03 in restitution to Regional Health Properties, Inc. (the former owner of Northridge Healthcare and Rehabilitation), plus a $500 fine and court costs. Brooks paid $3,600 in restitution prior to the guilty plea.
- November 20, 2017; Tennessee Department of Finance and Administration
- Houston Co. Woman Charged 2nd Time with TennCare Drug Fraud
NASHVILLE, Tenn. - A Houston County woman is charged for a second time with TennCare fraud involving prescription drugs.
- November 20, 2017; Tennessee Department of Finance and Administration
- White County Woman Charged with TennCare Fraud
NASHVILLE, Tenn. - A White County woman is charged with TennCare fraud for concealing information that disqualifies her and her children from the program.
- November 17, 2017; New York Attorney General
- A.G. Schneiderman Announces Indictment Against Pharmacy Owner, Pharmacist, And Three Pharmacies For Allegedly Defrauding Medicaid Of Over $3 Million
NEW YORK - Attorney General Eric T. Schneiderman today announced the indictment of Hin T. Wong ("Wong"), 49, of Manhattan, Mery Gooden, 58, of the Bronx, and three pharmacies. The indictment charges Wong, the owner of three Manhattan pharmacies - New York Pharmacy Inc. ("NY Pharmacy"), NYC Pharmacy Inc. ("NYC Pharmacy"), and New York Healthfirst Pharmacy Inc. ("NY Healthfirst") - for defrauding several government-funded healthcare programs, including Medicaid and Medicare, by falsely billing prescription refills and stealing over $3 million in reimbursement for medication they did not dispense. Wong was indicted for Grand Larceny in the First Degree, a class "B" felony, and other crimes. In addition, Mery Gooden, a pharmacist at NYC Pharmacy, was indicted for Grand Larceny in the Second Degree and other related crimes.
- November 17, 2017; Florida Attorney General
- Four Charged in Multistate Healthcare Fraud Conspiracy
TALLAHASSEE, Fla.-Attorney General Pam Bondi's Medicaid Fraud Control Unit, the United States Attorney's Office for the Northern District of Georgia and other federal and state partners announced the indictment of four individuals for healthcare fraud. The defendants face multiple counts of conspiracy to commit healthcare fraud and aggravated identify theft related to fraudulent claims filed with Florida, Georgia and Louisiana Medicaid programs. The four defendants owned or worked with companies that purportedly provided mental health counseling and treatment to children and adults.
- November 17, 2017; Florida Attorney General
- PlayBig Owner Arrested for Racketeering and Medicaid Provider Fraud
TALLAHASSEE, Fla.-Attorney General Pam Bondi's Medicaid Fraud Control Unit and the Leon Country Sheriff's Office today arrested Rachel Scharlepp, owner of PlayBig Therapy & Recreation Zone LLC, for racketeering and Medicaid provider fraud.
- November 16, 2017; Louisiana Attorney General
- Five Arrested in Louisiana for Medicaid Welfare Fraud
BATON ROUGE, LA - Attorney General Jeff Landry today announced the arrests of five Louisiana residents on Medicaid welfare fraud charges.
- November 16, 2017; Tennessee Department of Finance and Administration
- Gibson Co. Man Charged with TennCare Drug Fraud
NASHVILLE, Tenn. - A Gibson County man is charged with doctor shopping for prescription drugs, using TennCare as payment for the pills.
- November 15, 2017; New York Attorney General
- A.G. Schneiderman Announces Sentencing Of Binghamton-Area Transport Company And Owners For Stealing From Medicaid And Failing To Secure Workers' Compensation Insurance
BINGHAMTON - Attorney General Eric T. Schneiderman announced today the sentencings of Kenneth Cohn, Sharon Cohn, and Yellow Medi-Van and Taxi, Inc., for stealing hundreds of thousands of dollars in Medicaid funds and knowingly operating transportation services without Worker's Compensation insurance. At sentencing in Broome County Court, the Cohns forfeited and released $455,604 currently being withheld by the New York State Department of Health, to the Attorney General's Medicaid Fraud Control Unit. Each defendant also agreed to pay $50,000 in restitution, for a total of $100,000. Kenneth Cohn was sentenced to five years' probation, and Sharon Cohn was sentenced to one year conditional discharge. Yellow Medi-Van and Taxi, Inc. was sentenced to three years conditional discharge.
- November 14, 2017; Tennessee Department of Finance and Administration
- Bradley Co. Woman Pleads Guilty to TennCare Fraud
NASHVILLE, Tenn. - A Bradley County woman has pleaded guilty to TennCare fraud and must repay the state for healthcare insurance benefits she received.
- November 9, 2017; New York Attorney General
- A.G. Schneiderman Announces Sentencing Of Rochester Man For Stealing From And Defrauding Medicaid
ROCHESTER-Attorney General Eric T. Schneiderman today announced the sentencing of Nicholas Rice, of Rochester, NY. Rice stole over $6,000 from Medicaid by submitting false timesheets claiming that he provided home care services to a disabled Medicaid recipient. An investigation conducted by the Attorney General's office uncovered that Rice was not present to render the services that he purported to provide. Rice will now serve 1 1/2 to 3 years in state prison.
- November 8, 2017; Tennessee Department of Finance and Administration
- Giles, Lincoln Co. Residents Charged with TennCare Fraud
NASHVILLE, Tenn. - Residents of Giles and Lincoln Counties are charged with TennCare fraud in separate cases.
- November 8, 2017; Tennessee Department of Finance and Administration
- Giles, Lincoln Co. Residents Charged with TennCare Fraud
NASHVILLE, Tenn. - Residents of Giles and Lincoln Counties are charged with TennCare fraud in separate cases.
- November 7, 2017; Arkansas Attorney General
- Rutledge Announces Little Rock Woman Sentenced for Medicaid Theft
LITTLE ROCK - Arkansas Attorney General Leslie Rutledge today announced the conviction of a Little Rock woman for theft. Jene Wyatt pleaded guilty in Pulaski County District Court and has paid $1,438.56 in restitution to the Arkansas Medicaid Program Trust Fund. Wyatt will pay the same amount in fines to the General Fund of the State of Arkansas.
- November 6, 2017; Nevada Attorney General
- Attorney General Laxalt Announces Sentencing of Home Health Worker
Las Vegas, NV - Nevada Attorney General Adam Paul Laxalt announced that Babak Razzaghi-Shishavan, 39, of Las Vegas, was sentenced today in a Medicaid fraud case involving the failure to maintain proper documentation for services provided to a Medicaid recipient.
- November 3, 2017; Arkansas Attorney General
- Rutledge Announces Arrest of Helena-West Helena Man for Medicaid Fraud
LITTLE ROCK - Arkansas Attorney General Leslie Rutledge today announced the arrest of a Phillips County man.
- November 2, 2017; New York Attorney General
- A.G. Schneiderman Announces Jail Sentence For Registered Nurse Convicted Of Stealing Over $390,000 From Medicaid
WESTCHESTER - Attorney General Eric T. Schneiderman today announced the guilty plea of registered nurse Collins Anyanwu-Mueller, 47, for stealing over $390,000 from Medicaid. An investigation conducted by the Attorney General's Office revealed that over the course of nearly five years, Anyanwu-Mueller submitted false claims for private duty nursing services that he never provided to two severely disabled patients.
- November 1, 2017; New York Attorney General
- A.G. Schneiderman Announces Guilty Plea Of Former Nursing Home Resident Who Sexually Abused Disabled Resident At Same Facility
COOPERSTOWN -- Attorney General Eric Schneiderman today announced the conviction of Homer Pearce, of Sidney, New York, a former resident at the Focus at Otsego Nursing and Rehabilitation Center who pleaded guilty to sexually abusing a disabled resident at the same nursing home. Pearce, 79, pled guilty before the Honorable John F. Lambert in Otsego County Court of Sexual Abuse in the First Degree, a class D felony. Pearce was sentenced to two years in prison.
October 2017
- October 30, 2017; North Carolina Attorney General
- Attorney General Josh Stein Announces Health Care Fraud Conviction
(RALEIGH) Attorney General Josh Stein announced today that Rosa Powell pled guilty to two felonies involving a scheme to defraud Medicaid and pay illegal kickbacks. Powell was sentenced to sixty months on supervised probation in Pitt County Court and faces twelve to seventeen months in prison if she violates her probation. She also will restore $49,438.48 to taxpayers via the state's Medicaid fund.
- October 27, 2017; Florida Attorney General
- Georgia Resident Arrested for Exploiting Elderly Pensacola Resident
Tallahassee, Fla.-Attorney General Pam Bondi's Medicaid Fraud Control Unit and the Rockdale County Sheriff's Office announced today's arrest of a Georgia man for exploiting an elderly and disabled resident in an assisted living facility in Pensacola. The Medicaid Fraud Control Unit received a tip regarding this illegal activity from the Florida Department of Children and Families hotline.
- October 27, 2017; Pennsylvania Attorney General
- Allegheny County Doctor Charged with Illegally Distributing Opioids
HARRISBURG - A Pittsburgh-area doctor has been charged with unlawfully distributing controlled substances and conspiracy in a case being jointly investigated and prosecuted by the U.S. Attorney's Office for the Western District of Pennsylvania and the Office of Attorney General Josh Shapiro.
- October 26, 2017; New York Attorney General
- A.G. Schneiderman Announces Nurse Arrest For Failing To Give Critical Medications To Nursing Home Residents
PUTNAM COUNTY - Attorney General Eric T. Schneiderman today announced the arrest of Stacy E. McAdams, 47, a licensed practical nurse formerly employed by Putnam Ridge Nursing and Rehabilitation Center in the Town of Brewster for allegedly failing to administer prescribed medications to three residents. It is alleged that McAdams failed to administer anti-seizure medication to a resident with a history of seizures, anticoagulant medication to a resident at risk for blood clots, and blood pressure and heart medication to a resident with congestive heart failure and chronic obstructive pulmonary disease. McAdams made entries into each of the residents' medical records, falsely indicating that she administered the medication.
- October 25, 2017; New York Attorney General
- A.G. Schneiderman Announces Arrest Of Rochester Man For Misusing Medicaid To Sell Opioid Prescriptions
ROCHESTER-Attorney General Eric T. Schneiderman today announced the arrest of Ronald Lockwood, 44, for allegedly misusing Medicaid benefits to illegally fill and sell opioid prescriptions. The arrest follows an extensive joint investigation, in which the Attorney General's Medicaid Fraud Control Unit collaborated with law enforcement partners to uncover that Lockwood allegedly caused Medicaid to be billed over $12,000 for 12,500 Oxycodone pills and sold them to drug dealers in the Rochester area. The complaint, filed in Greece Town Court, charges Lockwood with Criminal Possession and Sale of a Controlled Substance in the Third Degree, both B felonies, and Grand Larceny in the Third Degree, a class D felony. If convicted, Lockwood faces up to nine years in prison.
- October 24, 2017; Arkansas Attorney General
- Rutledge Announces Arrest of Three Mississippi Women for Fraud
LITTLE ROCK - Arkansas Attorney General Leslie Rutledge today announced the arrest of three Mississippi women.
- October 19, 2017; Tennessee Department of Finance and Administration
- Wilson Co. Woman Must Repay TennCare
NASHVILLE, Tenn. - A Wilson County woman must repay the state for healthcare benefits, after court hearings involving charges of TennCare fraud.
- October 18, 2017; Florida Attorney General
- Lee County Man Sentenced to 20 Years for Exploiting an Elderly Person
TALLAHASSEE, Fla.-Attorney General Pam Bondi's Medicaid Fraud Control Unit announced the sentencing of a Lee County man for exploiting an elderly relative residing in a nursing home. Last month, a jury found Ryan Todd Powers, 41, guilty on four counts of first-degree exploitation involving an elderly person. This week, the Honorable J. Frank Porter, Circuit Judge for the 20th Judicial Circuit, sentenced Powers to 20 years in prison.
- October 18, 2017; Tennessee Department of Finance and Administration
- Former Mississippi Woman Charged with TennCare Fraud
NASHVILLE, Tenn. - A Shelby County woman who previously lived in Mississippi is charged with TennCare fraud for falsely reporting her residence in order to obtain healthcare insurance benefits from the taxpayer-funded program.
- October 17, 2017; Illinois Attorney General
- Madigan: Chicago Woman Charged for Defrauding State of Nearly $1 Million in Medicaid Funding
Chicago - Attorney General Lisa Madigan announced that a Chicago woman was charged with Medicaid fraud and identity theft for defrauding the state out of nearly $1 million in Medicaid funding.
- October 17, 2017; Nevada Attorney General
- Attorney General Laxalt Announces Sentencing of Former Medicaid Provider Business Owner
Las Vegas, NV - Today, Nevada Attorney General Adam Paul Laxalt announced that Shawnnyce Dawson, 50, of Las Vegas, was sentenced for submitting false claims to Nevada Medicaid. The fraud occurred between January 2013 and March 2015.
- October 13, 2017; Florida Attorney General
- Assisted Living Facility Owner Arrested for Criminal Use of Personal ID Information
TALLAHASSEE, Fla.-Attorney General Pam Bondi's Medicaid Fraud Control Unit today arrested an Escambia County resident for criminally using someone's personal identification information. Aisha Westbrooks, 40, is the owner of the assisted living facility House of Honor The Westbrooks Inc. According to the investigation, Westbrooks illegally used the information of an employee's sister to hide the identity of the same employee, who is a convicted felon. Westbrooks also allegedly used this information to bill Medicaid and private pay clients for more than $15,000 in services provided by the employee, who is not eligible to work for a Medicaid provider.
- October 11, 2017; U.S. Attorney; Western District of Texas
- Austin Area Patient Recruiter Pleads Guilty to Receiving Kickbacks in Health Care Fraud Scheme
In Austin this afternoon, 68-year-old patient recruiter Glen Elwood McKenzie, Jr., of Cedar Park, TX, pleaded guilty to federal charges in connection with a Health Care Fraud scheme announced United States Attorney Richard L. Durbin, Jr., FBI Special Agent in Charge Christopher Combs, San Antonio Division, and Texas Attorney General Ken Paxton.
- October 9, 2017; Nevada Attorney General
- Attorney General Laxalt Announces Sentencing of Group Home Caregiver
Las Vegas, NV - Nevada Attorney General Adam Paul Laxalt announced today that Portia Cimperman, 44, was sentenced for Neglect of an Older Person, a gross misdemeanor offense.
- October 9, 2017; Tennessee Department of Finance and Administration
- Residents of Cocke, Hawkins Counties Charged with TennCare Drug Fraud
NASHVILLE, Tenn. - Residents of Cocke and Hawkins Counties are charged in separate cases involving TennCare fraud.
- October 4, 2017; Georgia Attorney General
- Attorney General Carr Announces Guilty Plea in Medicaid Fraud Trial
ATLANTA, GA -Attorney General Chris Carr today announced that on Monday, October 2, 2017, Defendant Casandra Jones plead guilty, midway through trial, to one count of Medicaid Fraud (O.C.G.A. � 49-4-146.1(b)), one felony count of Conspiracy to Defraud the State (O.C.G.A. � 16-10-21) and two felony counts of Forgery in the second degree (O.C.G.A. � 16-9-1).
- October 3, 2017; Massachusetts Attorney General
- Pharmaceutical Company Mylan to Pay $20.3 Million for Underpaying Rebates on Epipens for Masshealth Members
BOSTON - Pharmaceutical company Mylan will pay a total of $20.3 million to the Massachusetts Medicaid program (MassHealth) to resolve allegations that it knowingly underpaid rebates owed to the Medicaid program for EpiPens dispensed to MassHealth members, Attorney General Maura Healey announced today.
- October 3, 2017; U.S. Attorney; Southern District of Texas
- Nurse Imposter Sent to Prison for Health Care Fraud
VICTORIA, Texas - A 43-year-old former resident of Goliad has been ordered to prison after she admitted to repeatedly posing as a nurse, announced acting U.S. Attorney Abe Martinez. Leticia Gallarzo pleaded guilty on July 6, 2017, to five counts of making false statements relating to health care.
- October 3, 2017; Florida Attorney General
- Pinellas County Resident Arrested for Exploitation of an Elderly Person
TALLAHASSEE, Fla.-Attorney General Pam Bondi's Medicaid Fraud Control Unit and the Pinellas County Sheriff's Office today arrested Curtis Johnson, 55, for exploiting an elderly person. Johnson possessed power of attorney for an elderly relative residing in an assisted living facility and arranged for the relative's pension checks to be electronically deposited into an account under Johnson's control. According to the MFCU investigation, Johnson did not pay the monthly responsibility for the relative to stay in the facility, and instead used the money for personal benefit.
- October 2, 2017; Tennessee Department of Finance and Administration
- Cumberland County Man Charged with TennCare Fraud
NASHVILLE, Tenn. - A Cumberland County man is charged with TennCare fraud in connection with selling prescription drugs he obtained using TennCare benefits.
