Medicare Fraud Reports From the Office of Inspector General and Recent State Enforcement Actions

June 2015

June 29, 2015; New York Attorney General: A.G. Schneiderman Announces $2.5 Million Settlement With NYC Pharmacy For Improper Medicaid Billings
NEW YORK - Attorney General Eric T. Schneiderman today announced a settlement that returns $2.5 million to the state's Medicaid program. The agreement reached with Trinity Homecare LLC, a pharmacy primarily owned by Walgreen Co., began with a whistleblower claim of improper conduct and false Medicaid billings related to drugs mainly prescribed for hemophilia patients. The court approved settlement resolves claims of undocumented delivery by the pharmacy of infusion drugs. In at least one instance, these expensive drugs were allegedly left outside a patient's home without signature by the patient. The drugs can cost tens of thousands of dollars per delivery. Located in College Point, Queens, Trinity also allegedly submitted claims to Medicaid for a greater amount of drugs than it could document were actually delivered.
June 24, 2015; Florida Attorney General: Orange County Man Arrested for Abuse of Disabled Adult
TALLAHASSEE, Fla.-Attorney General Pam Bondi's Medicaid Fraud Control Unit and the Orange County Sheriff's Office today arrested a former employee of Health Central Hospital in Ocoee, Fla., Roger Lea Scherer, for abuse of a disabled adult. The victim suffers from a mental disease that can cause the loss of limb control. According to the investigation, the victim's flailing arms hit Scherer and he retaliated by allegedly punching the victim in the chest.
June 24, 2015; Florida Attorney General: Treasure Coast Man Arrested for Abuse of a Disabled Adult
TALLAHASSEE, Fla. -Attorney General Pam Bondi's Medicaid Fraud Control Unit and the Port St. Lucie Police Department today arrested a former mental health technician of Treasure Coast Forensic Treatment Center, in Indiantown, for abuse of a disabled adult. According to the investigation, Byron Pressley, 22, punched one of the residents in the face. The incident was captured on video.
June 24, 2015; New York Attorney General: A.G. Schneiderman Announces Arrests Of Three Nursing Home Caregivers For Alleged Neglect And Abuse Of A Disabled Resident
NEW YORK, NY - Attorney General Eric T. Schneiderman today announced the arrests of two nurses and one nurses aide for allegedly dragging a disabled and bleeding patient across the hallway floor at Peninsula Nursing and Rehabilitation Center, located in Far Rockaway, New York, and for neglecting to treat that patient as he lay on the floor bleeding from his head for over twenty minutes. These acts of neglect and abuse were captured by facility-maintained surveillance cameras, according to court papers.
June 23, 2015; Georgia Attorney General: Columbus Woman Sentenced to Prison for Medicaid Fraud
On Monday, June 23, 2015, Della Upshaw of Columbus, Ga., pleaded guilty in Muscogee Superior Court to one count of Medicaid Fraud (O.C.G.A. § 49-4-146.1(b)). She also pleaded guilty to one count of Insurance Fraud (O.C.G.A. § 33-1-9), a charge brought by Muscogee County District Attorney Julia Slater. Judge Ronald Mullins sentenced Upshaw to one year in prison, followed by nine years probation and restitution in the amount of $98,344.15.
June 23, 2015; Tennessee Department of Finance and Administration: Alabama Woman Charged for the 2nd Time with TennCare Fraud
NASHVILLE, Tenn. - An Alabama woman is charged a second time with TennCare fraud for falsely reporting her residency in order to obtain healthcare insurance benefits through the state's TennCare program.
June 23, 2015; Tennessee Department of Finance and Administration: Dickson County Woman Charged with Doctor Shopping
(NASHVILLE, Tenn.) - A Dickson County woman is charged with TennCare fraud involving doctor shopping, which is the crime of going to multiple doctors in a short period of time to obtain controlled substances, using TennCare as payment.
June 22, 2015; Georgia Attorney General: Four Individuals Charged with Medicaid Fraud in Henry County
On Thursday, June 11, 2015, a Henry County Grand Jury charged Casandra Jones, Fredrick Thrasher, Antoine Johnson and Lynesha McElveen with one felony count of Medicaid Fraud (O.G.G.A. § 49-4-146.1(b)) and one felony count of Conspiracy to Defraud the State (O.C.G.A. § 16-10-21). Casandra Jones was charged with 38 additional counts of Forgery (O.C.G.A. § 16-9-1).
June 22, 2015; New York Attorney General: A.G. Schneiderman Announces Arrest Of Nursing Home Aide For Allegedly Neglecting Elderly Resident In Westchester County Nursing Home Causing Injury
Pearl River - Attorney General Eric T. Schneiderman today announced the arrest of Ekua Hakikson, a Certified Nurse Aide who worked at United Hebrew Geriatric Center in New Rochelle for allegedly dropping an 85-year-old patient from a mechanical lift. On August 29, 2013, Hakikson attempted to move the resident by herself with the use of a mechanical lift. During the transfer, the resident allegedly fell to the floor, suffering injuries to her nose, temple and shoulder.
June 19, 2015; Louisiana Attorney General: Medicaid Fraud Control Unit Arrests St. Martin Parish Woman
Attorney General Buddy Caldwell announced today that a St. Martinville woman has been arrested for Medicaid fraud after causing false claims to be submitted to the Louisiana Medicaid Program for health-care services that were not performed.
June 18, 2015; New York Attorney General: A.G. Schneiderman Announces Settlement With Aspen Dental Management That Bars Company From Making Decisions About Patient Care In New York Clinics
NEW YORK - Attorney General Eric T. Schneiderman today announced a settlement with Aspen Dental Management, Inc., an East Syracuse-based company that provides business support and administrative services to seven independently owned dental practices that maintain 40 offices in New York State. The settlement requires Aspen Dental Management, a company with a reported $645 million in annual revenue, which operates nationwide, to overhaul the way it does business in New York, so that it does not dictate the care provided by dentists and hygienists at dental practices, does not split patients' fees with the clinics, which is illegal in New York, and makes clear to consumers that Aspen Dental Management is not a provider of dental services.
June 16, 2015; Pennsylvania Attorney General: Attorney General Kane announces arrest of five as result of Medicaid fraud investigations
HARRISBURG - Attorney General Kathleen G. Kane today announced the arrest of five individuals charged with Medicaid fraud after unrelated investigations across the Commonwealth.
June 16, 2015; New York Attorney General: A.G. Schneiderman Announces Arrest Of Capital Region Personal Care Aides For Allegedly Defrauding Medicaid For Services Never Provided
ALBANY- Attorney General Eric T. Schneiderman today announced the arrest of personal care aides Robert Lee Van Horne and Nicholas Gallup in Albany. Van Horne and Gallup were arraigned in Albany City Court in front of the Hon. William Carter. Van Horne, 33 and Gallup, 27, both of Schenectady, were arraigned on multiple counts of Falsifying Business Records in the First Degree, and Grand Larceny in the Fourth Degree, both Class E felonies. It is charged that both defendants caused more than 50 false entries in the business records of Capital District Physicians Health Plan (CDPHP), a Medicaid Managed Care contractor for New York State, located in the City of Albany, and stole property in excess of one thousand dollars.
June 15, 2015; Tennessee Department of Finance and Administration: Arkansas Woman Charged with TennCare Fraud
NASHVILLE, Tenn. - An Arkansas woman is charged with TennCare fraud and theft of property after she received healthcare insurance benefits through the state's healthcare insurance program, even though she was not eligible.
June 15, 2015; New York Attorney General: A.G. Schneiderman Announces Arrest Of Nurse Who Allegedly Used Forged Prescriptions To Illegally Obtain Narcotic Medication
AMHERST - Attorney General Eric T. Schneiderman today announced the arrest of Leyla Samadi, 53, a Registered Nurse, of Germantown, MD, for allegedly presenting four forged prescriptions to CVS Pharmacy, located at 9300 Transit Road in Amherst, in order to illegally obtain the narcotic medication Percocet.
June 12, 2015; Tennessee Department of Finance and Administration: Lauderdale Co. Woman Charged With TennCare Fraud
NASHVILLE, Tenn. - A Lauderdale County woman is charged with TennCare fraud for selling her prescription drugs, which were paid for by TennCare.
June 11, 2015; Massachusetts Attorney General: Medway Woman Pleads Guilty, Sentenced to Prison for Defrauding MassHealth and Filing False Insurance Claims
BOSTON - A Medway woman has pleaded guilty and been sentenced to one year in state prison in connection with fraudulently billing MassHealth and profiting more than $1 million from the sale of medical products obtained through the filing of false health care claims, Attorney General Maura Healey announced today. She was also ordered to pay $57,288 in restitution.
June 11, 2015; South Dakota Attorney General: Madison Man Sentenced in Medicaid Fraud Case
PIERRE, S.D. - Attorney General Marty Jackley announced today that Shawn Earl Nills, 42, Madison, was sentenced to serve 5 years in the State Penitentiary for committing Medicaid fraud.
June 11, 2015; Louisiana Attorney General: State to Settle Medicaid Fraud Case with Pharmacy Company
Attorney General Buddy Caldwell announced today that his office has reached a settlement in principle in a Medicaid fraud case in which a Tennessee-based specialty pharmacy company is accused of illegally receiving kickbacks for recommending a certain drug to Medicaid beneficiaries.
June 10, 2015; Georgia Attorney General: Georgia Dentist Convicted of Misuse of Medicaid Funds
On June 5, 2015, Attorney General Sam Olens announced the conclusion of a multi-part investigation into Dr. Dennis B. Jaffe's Atlanta-based dentistry practice. After a joint investigation conducted by the Georgia Medicaid Fraud Control Unit and federal partners, Dr. Jaffe, D.M.D., pled guilty to criminal charges and civilly settled allegations of fraud for $324,327.05.
June 10, 2015; New York Attorney General: A.G. Schneiderman Announces Arrest Of Four Nurses Charged With Failing To Properly Monitor Disabled Patient
WOODMERE-Attorney General Eric T. Schneiderman announced the arrests of four nurses who worked at Woodmere Rehabilitation and Health Care Center for allegedly failing to monitor a disabled patient as ordered by the patient's physician. As a result, the patient fell and was injured.
June 10, 2015; New York Attorney General: A.G. Schneiderman Announces Arrest Of LPN For Allegedly Falsifying Medication Records To Conceal Neglect Of Four Nursing Home Residents
BUFFALO - Attorney General Eric T. Schneiderman today announced the arrest of Christine Peckey, 59, of Buffalo, NY, for allegedly failing to administer medication to four residents of Mercy Hospital Skilled Nursing Facility at OLV ("OLV"), located at 55 Melroy Avenue in Lackawanna, and then falsifying the Medication Administration Record ("MAR") for each resident to reflect that she had administered the medication.
June 10, 2015; New York Attorney General: A.G. Schneiderman Announces Arrests Of Six NYC And Westchester Home Health Aides Charged With Defrauding Medicaid
NEW YORK - Attorney General Eric T. Schneiderman today announced the arrests of six home health care workers who worked in the Bronx, Kings, New York, Richmond and Westchester Counties accused of defrauding the New York State Medicaid Program, either directly or through a Medicaid managed care plan. The defendants are charged separately, including allegations against four of them for defrauding the program of more than $30,000. They were arrested and charged with a variety of felonies, including identity theft, grand larceny and possession of forged documents for faking home-health care credentials and submitting false billings for services which were never rendered.
June 9, 2015; New Jersey Department of Law and Public Safety: Mayor of West New York Indicted for Allegedly Receiving Bribes Totaling Approximately $250,000 in Exchange for Referring Patients to Medical Imaging Centers Led By Criminal Network
TRENTON - Acting Attorney General John J. Hoffman and the Office of the Insurance Fraud Prosecutor (OIFP) announced today that West New York Mayor Dr. Felix Roque was indicted for referring patients to the medical imaging company Diagnostic Imaging Affiliates in exchange for cash bribes and other kickbacks.
June 9, 2015; New York Attorney General: A.G. Schneiderman Announces Arrest Of Rochester Woman Allegedly Involved In Fraudulent Billing Medicaid $13,000
ROCHESTER - Attorney General Eric T. Schneiderman today announced Maria Quinones, 43, of Rochester, was charged with Grand Larceny, a felony, in Rochester City Court, for causing the New York State Medicaid program to be illegally billed more than $13,000. It is alleged that Quinones falsely claimed to have a college degree in order to obtain a job at The Community Place of Greater Rochester (CPGR). CPGR then billed Medicaid for client services performed by Quinones. State Medicaid regulations require providers to have at least an associate's degree or be a Registered Nurse.
June 8, 2015; Connecticut Attorney General: State Reaches Settlements with Three Defendants in Alleged Fraudulent Medicaid Billing Lawsuit
The state has executed settlement agreements with three defendants that resolve civil fraud allegations and claims stemming from an illegal Medicaid dental billing scheme, Attorney General George Jepsen said today.
June 8, 2015; Louisiana Attorney General: Two Caregivers Arrested For Cheating Medicaid Program
Attorney General Buddy Caldwell announced today that two caregivers have been arrested for Medicaid fraud after illegally billing the Louisiana Medicaid Program for services that were not performed.
June 5, 2015; Tennessee Department of Finance and Administration: Wilson Co. Woman Charged With TennCare Fraud
NASHVILLE, Tenn. - A Wilson County woman is charged in Nashville with TennCare fraud involving doctor shopping, which involves going to multiple doctors in a short period of time to obtain prescriptions for controlled substances, and using TennCare as payment.
June 4, 2015; Georgia Attorney General: Attorney General Olens Announces Settlement with Health Management and Associates and Clearview Regional Medical Center to Resolve Kickback Allegations
Attorney General Sam Olens announced today that Georgia has reached a civil settlement agreement with Health Management Associates, Inc. (HMA) and Clearview Regional Medical Center. The hospital, which is located in Monroe, Ga., was previously named Walton Regional Medical Center and was owned by hospital operator HMA during the time period relevant to the lawsuit. It is now owned by Community Health Systems.
June 3, 2015; New Jersey Department of Law and Public Safety: Five Medical Practitioners Indicted for Taking Bribes in Exchange for Referring Patients to Medical Imaging Centers Run by Criminal Enterprise
TRENTON - Acting Attorney General John J. Hoffman and the Office of the Insurance Fraud Prosecutor (OIFP) announced today that five medical practitioners were indicted for referring patients to medical imaging company Diagnostic Imaging Affiliates in exchange for cash bribes and other kickbacks.
June 3, 2015; New York Attorney General: A.G. Schneiderman Announces Arrest Of Nursing Home Aide For Causing Injury To A 74 Year Old Resident
CLIFTON PARK - Attorney General Eric T. Schneiderman today announced the arrest and arraignment of Fiona Jennings, a Certified Nurse Assistant on charges that she endangered the welfare of a nursing home resident at Seton Health at Schuyler Ridge. Jennings allegedly failed to provide appropriate care to a 74 year old woman, resulting in a fall, which Jennings failed to report. The resident sustained significant injuries to her face as a result.
June 2, 2015; New Mexico Attorney General: Attorney General Complaints Allege Medicaid Fraud at Carlsbad-area Mental Health Center
Carlsbad, NM - Attorney General Hector Balderas' office today charged four top personnel at Carlsbad Mental Health Center with Medicaid fraud and also brought charges against the center as a corporation. Criminal complaints against the four individuals - Michael Stoll, Noel Clark, Darrill Woodfield and John Bain - and the corporation were filed June 2, 2015, in Eddy County Magistrate Court. The corporation and each of the individuals was charged with eight counts of Medicaid fraud under the Medicaid Fraud Act, one count of conspiracy and one count of fraud involving non-Medicaid funds.
June 2, 2015; Tennessee Department of Finance and Administration: Sullivan Co. Man Charged With TennCare Drug Fraud
NASHVILLE, Tenn. - A Sullivan County man is charged with TennCare fraud for selling prescription drugs paid for by TennCare.

May 2015

May 29, 2015; New York Attorney General: A.G. Schneiderman Announces Sentencing Of Rochester Man Who Posed As Doctor In Order To Illegally Obtain Drugs
ROCHESTER-Attorney General Eric T. Schneiderman announced the sentencing of William Martinez, age 34 of Rochester, who previously pled guilty for pretending to be a doctor in order to unlawfully obtain narcotics from a pharmacy using his Medicaid benefits card. Martinez was sentenced to a determinate prison term of 1.5 years, 1.5 years post-release supervision and restitution for the cost to the Medicaid program.
May 29, 2015; Missouri Attorney General: AG Koster files felony charges in Camden County Medicaid fraud case
Jefferson City, Mo. - Attorney General Chris Koster announced today that a Camdenton woman Lisa Long, age 52, of Camdenton, has been charged with two felony counts of Medicaid fraud. The Attorney General's Medicaid Fraud Control Unit is assisting Camden County Prosecuting Attorney Michael Gilley in the prosecution.
May 26, 2015; Alabama Attorney General: AG Announces Arrest of Mobile Dentist for Medicaid Fraud
(MONTGOMERY)- Attorney General Luther Strange announced the arrest of a Mobile dentist, William Gerard Eastburn, on one count of filing false claims with the Alabama Medicaid Agency and one count of first-degree theft of property.
May 26, 2015; New York Attorney General: A.G. Schneiderman Announces Guilty Plea Of Rochester Woman Who Submitted False Time Sheets To Medicaid For The Care Of Her Daughter
ROCHESTER, NY - Attorney General Eric Schneiderman today announced the arraignment, guilty plea and sentencing of Patricia Power for Petit Larceny based upon criminal charges filed by his office. Power, the mother of a disabled adult from Farmington, submitted phony time sheets to Medicaid for personal care work that the daughters of Power did not perform for their sister
May 26, 2015; Tennessee Department of Finance and Administration: Jefferson County Woman Charged With TennCare Doctor Shopping
NASHVILLE, Tenn. - A Jefferson County woman is charged with TennCare fraud involving "doctor shopping," or using TennCare to go to multiple doctors in a short time period to obtain controlled substances.
May 26, 2015; Tennessee Department of Finance and Administration: Cannon County Woman Charged With TennCare Doctor Shopping
NASHVILLE, Tenn. - A Cannon County woman is charged for a second time with TennCare fraud involving prescription drugs.
May 22, 2015; Louisiana Attorney General: AG Buddy Caldwell Announces Two Arrests Following Investigations Into Medicaid Fraud
A Baton Rouge medical transportation provider and a New Orleans personal care attendant are facing charges involving separate schemes to defraud the state's Medicaid program, Attorney General Buddy Caldwell announced today.
May 21, 2015; Florida Attorney General: Two Osceola County Women Arrested for Medicaid Fraud
TALLAHASSEE, Fla.-Attorney General Pam Bondi's Medicaid Fraud Control Unit, the Osceola County Sheriff's Office and the Osceola County Probation and Parole Services today arrested two Osceola County women for allegedly billing the Medicaid program for more than $94,000 in fraudulent services.
May 20, 2015; Tennessee Department of Finance and Administration: Giles Co. Woman Facing 5th TennCare Fraud Charge
NASHVILLE, Tenn. - A Giles County woman is charged with TennCare fraud for the fifth time.
May 20, 2015; New York Attorney General: A.G. Schneiderman Announces Arrest of Southern Tier Nurse for Allegedly Diverting Narcotics from Nursing Home Patients
ELMIRA - Attorney General Eric T. Schneiderman today announced the arrest of Lisa Rumsmoke Clark, 45, a Licensed Practical Nurse from Watkins Glen, on charges that she allegedly diverted nearly 200 narcotic pills from elderly patients residing at Elcor Nursing and Rehabilitation Center in Horseheads.
May 19, 2015; Tennessee Department of Finance and Administration: Two in East Tennessee Charged With TennCare Fraud
NASHVILLE, Tenn. - A Blount County woman and a man from Hamilton County are charged in separate cases involving TennCare fraud. The Office of Inspector General (OIG) today announced the arrests.
May 18, 2015; Massachusetts Attorney General: AG Healey Takes Action Against Hyannis Physician for Illegally Prescribing Opioids
BOSTON - Delivering on her promise to tackle the opioid and heroin epidemic from all angles, Attorney General Maura Healey announced today that a Hyannis physician has been indicted for illegally prescribing opioids and defrauding the state's Medicaid program (MassHealth).
May 15, 2015; Missouri Attorney General: Attorney General Koster announces judgment against St. Louis personal care attendant
Jefferson City, Mo. - Attorney General Chris Koster announced today that his office has obtained a civil judgment against a St. Louis personal care attendant for submitting false claims to Medicaid.
May 15, 2015; New York Attorney General: A.G. Schneiderman Announces Guilty Plea Of Former Rochester Pharmacy Technician Who Posed As Doctor To Illegally Obtain Prescription Narcotics
ROCHESTER - Attorney General Eric T. Schneiderman today announced the guilty plea of William Martinez, 34, of Rochester, who admitted in court to posing as a doctor in order to unlawfully obtain narcotics from a pharmacy using his Medicaid benefits card. Martinez pleaded guilty to Criminal Possession of a Controlled Substance in the 4th Degree, a Class C felony, before The Honorable Melchor Castro in Monroe County Court. Mr. Martinez is expected to receive a determinate prison term of 1.5 years, 1.5 years of post-release supervision, and restitution for the cost to the Medicaid program when sentencing occurs on May 29.
May 15, 2015; Tennessee Department of Finance and Administration: Bradley Co. Woman Charged Third Time With TennCare Fraud
NASHVILLE, Tenn. - A Bradley County woman is charged for the third time with doctor shopping for prescription drugs, using TennCare benefits as payment.
May 14, 2015; Missouri Attorney General: AG Koster obtains additional $1.2 million for Missouri from Medicaid fraud settlement
Jefferson City, Mo. - Attorney General Chris Koster announced today that Missouri's Medicaid program recovered an additional $2.5 million for the state and federal government as a result of Universal American Corp's (UA) sale of APS Healthcare, Inc. (APS). The additional recovery is part of the March 17, 2015, settlement agreement between APS, the United States, and Missouri. Thus far, APS has paid nearly $7 million to the state and federal government, with $3,643,500 of that amount for Missouri.
May 14, 2015; New York Attorney General: A.G. Schneiderman Announces Arrest Of Nurse Charged With Stealing Percocet Pills From Nursing Home
CATSKILL - Attorney General Eric T. Schneiderman today announced the arrest and arraignment of Rachael Cornell, a Licensed Practical Nurse (L.P.N.), on charges that she stole Percocet pills from Kaaterskill Care Skilled Nursing and Rehabilitation for personal use and destroyed the narcotic record to try to cover up her theft.
May 14, 2015; Tennessee Department of Finance and Administration: 3 Charged With TennCare Fraud in Hamblen, Greene Counties
NASHVILLE, Tenn. - Three people are charged separately with TennCare fraud in Greene and Hamblen Counties. All three cases involve efforts to obtain prescription pain medication, using TennCare healthcare insurance benefits to pay for the drugs.
May 14, 2015; Louisiana Attorney General: Medicaid Fraud Control Unit Arrests New Orleans Woman
Attorney General Buddy Caldwell announced today that a New Orleans woman has been arrested for Medicaid fraud after illegally billing the Louisiana Medicaid Program for health-care services that were not performed.
May 13, 2015; Tennessee Department of Finance and Administration: Weakley Co. Woman Charged With TennCare Drug Fraud
NASHVILLE, Tenn. - A Weakley County woman faces multiple TennCare fraud charges in connection with using the state healthcare insurance program to pay for fraudulent prescriptions.
May 13, 2015; Missouri Attorney General: AG Koster files felony charges in Dent County Medicaid fraud case
Jefferson City, Mo. - Attorney General Chris Koster announced today that three individuals from Salem have been charged with multiple felony counts of Medicaid fraud. The Attorney General's Medicaid Fraud Control Unit is assisting Dent County Prosecuting Attorney Andrew Curley in the prosecution.
May 11, 2015; New Jersey Department of Law and Public Safety: Owner of Medical Imaging Centers to Receive 10-Year Prison Sentence After Pleading Guilty to Bribing Dozens of Doctors in Exchange for Scan Referrals Worth Several Million Dollars
TRENTON - Acting Attorney General John J. Hoffman and the Office of the Insurance Fraud Prosecutor (OIFP) announced today that the ringleader of a major criminal enterprise and his wife pleaded guilty to charges that they bribed dozens of doctors in exchange for referrals, worth several million dollars, to the medical imaging centers they owned and operated. It was also announced that three other co-conspirators in the bribery scheme pleaded guilty to their roles.
May 11, 2015; Nevada Attorney General: Attorney General Laxalt Announces Sentencing of Medicaid Provider for Failure to Maintain Adequate Records
Las Vegas, NV - Nevada Attorney General Adam Paul Laxalt announced that Michiko Nicole Martin, 34, of Las Vegas, was sentenced last week for Medicaid fraud. The judge sentenced Martin on one gross misdemeanor charge of intentional failure to maintain adequate records. The fraud was committed between May 2012 and July 2013.
May 7, 2015; Pennsylvania Attorney General: Seven charged with Medicaid fraud after investigations by Attorney General Kane's office
HARRISBURG - Attorney General Kathleen G. Kane today announced the arrest of seven individuals charged with Medicaid fraud after unrelated investigations across the Commonwealth.
May 6, 2015; New York Attorney General: A.G. Schneiderman Announces Guilty Plea And Jail Sentence For Owner Of Westchester Transportation Company Who Stole More Than $200,000 From Medicaid
PEARL RIVER - Attorney General Eric T. Schneiderman today announced that Carewell Ambulette, Inc. and its owner, Kurien Palliankal, 48, of Yonkers, have pleaded guilty to stealing more than $200,000 from the Medicaid program. The company, formerly based in New Rochelle, provided transportation services to Medicaid recipients throughout Westchester and neighboring counties. Palliankal will be sentenced to six months in jail, followed by five years of probation, and will also be required to pay full restitution to Medicaid.
May 6, 2015; New York Attorney General: A.G. Schneiderman Announces Guilty Plea Of Westchester Nonprofit Executive For Stealing From State Program Assisting Seniors And Disabled
PEARL RIVER - Attorney General Eric T. Schneiderman today announced that Darlington Odidika, executive director of Yonkers-based nonprofit Systems and Abilities, Inc., pleaded guilty to his role in a bid-rigging and kickback scheme to defraud the Medicaid system of monies earmarked to allow the elderly and infirm to live in the community, rather than in an institutional setting. As a condition of today's plea, Odidika, 47, of Poughkeepsie, will be sentenced to three months in jail and five years of probation. Odidika and the corporation are also required to repay the full amount that was stolen from Medicaid as a result of this scheme.
May 5, 2015; Idaho Attorney General: Pullman Dentist Sentenced for Medicaid Fraud
(Boise) - An Eastern Washington dentist, Alfred Fairbanks, convicted of four felony counts of provider fraud, has been sentenced to five years in prison, Attorney General Lawrence Wasden announced today. The court suspended the prison sentence.
May 1, 2015; Mississippi Attorney General: Wisconsin Woman Arrested for Felony Exploitation of Vulnerable Person
A Wisconsin resident has been arrested following indictment for felony exploitation of a vulnerable person, announced Attorney General Jim Hood today.
May 1, 2015; New Jersey Department of Law and Public Safety: Monmouth County Woman Sentenced to Three Years in Prison for Submitting Approximately $500,000 in Fraudulent Healthcare Claims to Insurer
TRENTON - Acting Attorney General John Hoffman and the Office of the Insurance Fraud Prosecutor (OIFP) announced that a Monmouth County woman received a three-year state prison term for submitting fraudulent healthcare claims that totaled more than $500,000 to her insurer over a two-year span.

April 2015

April 30, 2015; Louisiana Attorney General: Four Arrested on Medicaid Fraud Charges
Attorney General Buddy Caldwell announced that four individuals were arrested after an investigation conducted by agents with his Medicaid Fraud Control Unit revealed the state's Medicaid Program was billed for in-home personal care services while the Medicaid recipients purported to be receiving care were actually on a Caribbean cruise.
April 30, 2015; Tennessee Department of Finance and Administration: TennCare Fraud Convictions Lead to Repayment for Services
NASHVILLE, Tenn. - Three people convicted of TennCare fraud will make restitution to the state totaling over $10,000.
April 29, 2015; New Jersey Department of Law & Public Safety: Former Passaic County Home Health Aide Sentenced to Three-Year State Prison Term for Falsely Billing Medicaid for Medical Services in No-Show Scam
TRENTON - Acting Attorney General John J. Hoffman and the Office of the Insurance Fraud Prosecutor (OIFP) announced that a former employee of a home health agency was sentenced to a three-year state prison term today for causing bills to be submitted to the Medicaid program for services that were never provided.
April 28, 2015; Massachusetts Attorney General: Former Charlestown Nonprofit to Pay More Than $94,000 for Billing MassHealth for Services Allegedly Not Provided
BOSTON - A former Charlestown nonprofit that provided day habilitation services to individuals with developmental disabilities has agreed to pay more than $94,000 to settle claims of billing the state's Medicaid program (MassHealth) for services not provided, Attorney General Maura Healey announced today.
April 28, 2015; New York Attorney General: A.G. Schneiderman Announces Charges Against Herkimer County Certified Nurse's Aide Accused of Striking a Nursing Home Resident
UTICA - Attorney General Eric T. Schneiderman today announced the arrest and arraignment of Renee Geloso, 24, of Ilion, who was arraigned on charges of Endangering the Welfare of an Incompetent or Physically Disabled Person in the First Degree and Willful Violation of the Public Health Law before Ilion Town Justice Stephen Canipe in Ilion Village Court. It is alleged that while working as a Certified Nurse Aide at the Valley Health Services in Herkimer, Geloso struck a resident when she became frustrated with the resident.
April 27, 2015; Tennessee Department of Finance and Administration: Coffee Co. Woman Charged With TennCare Fraud
NASHVILLE, Tenn. - A Coffee County woman is charged 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.
April 27, 2015; Tennessee Department of Finance and Administration: Eight People Charged With TennCare Fraud in Hamblen County Round-Up
NASHVILLE, Tenn. - Eight people have been arrested and charged with TennCare fraud, after a round-up that involved 105 individuals being charged in connection with prescription drugs. A total of 81 of them have been arrested.
April 27, 2015; Tennessee Department of Finance and Administration: Two Jefferson Co. Residents Charged with TennCare Fraud
NASHVILLE, Tenn. - Two people in Jefferson County are charged in separate cases involving TennCare prescription drug fraud.
April 24, 2015; Missouri Attorney General: AG Koster announces judgment against New Madrid County Medicaid provider
Jefferson City, Mo. - Attorney General Chris Koster announced today his office has obtained a civil judgment against Tina Hartlein, owner and operator of Caring Hands In Home Care, in Mathews, MO, for her company's submission of false claims to Missouri's Medicaid program. As part of the judgment, Hartlein has agreed to pay $115,298, which will be returned to Medicaid, along with $5,000 to cover investigative costs.
April 23, 2015; Georgia Attorney General: Grady Health System to Pay Over $2.9 Million to Resolve Improper Medicaid Billing Allegations
Attorney General Sam Olens announced on April 23, 2015, that the state of Georgia has reached a civil settlement agreement with Grady Health System (Grady). Grady has agreed to pay $2,950,000 to settle claims that it inaccurately coded claims for neo-natal intensive care unit (NICU) patients, resulting in alleged damages to the Georgia Medicaid program.
April 21, 2015; Rhode Island Attorney General: Owner of St. Jude Home Care Charged with Medicaid Fraud
Attorney General Peter F. Kilmartin announced that Priscilla Pascale (age 54), of Barrington, was charged with five counts of Medicaid fraud and five counts of conspiracy to commit Medicaid fraud. Ms. Pascale is the owner and operator of St. Jude Home Care, located at 445 Reservoir Avenue, Cranston. In addition, Orfa Lemaire (age 37), of East Greenwich, the director of clinical services, was charged with five counts of conspiracy to commit Medicaid fraud.
April 21, 2015; Tennessee Department of Finance and Administration: Georgia Woman Must Pay Tennessee for Healthcare After TennCare Fraud Conviction
NASHVILLE, Tenn. - A Georgia woman must pay Tennessee for healthcare insurance benefits received through TennCare, after her conviction for committing fraud to enroll in the program.
April 20, 2015; Tennessee Department of Finance and Administration: Bradley Co. Man Charged With TennCare Doctor Shopping
NASHVILLE, Tenn. - A Bradley County man is charged a second time with TennCare fraud involving doctor shopping for prescription drugs.
April 20, 2015; Kentucky Attorney General: Attorney General Conway Announces Plea and Sentencing of Former Hopkins County Caretaker
Attorney General Jack Conway and his Medicaid Fraud and Abuse Control Unit today announced an Alford plea of guilty and sentencing of a former certified medical technician (CMT) on two counts of Wanton Caretaker Abuse or Neglect. This morning, 35-year-old Terri Henry of Hopkins County was sentenced in Hopkins Circuit Court to three years prison, which will be diverted for a period of five years. Henry was ordered to give up her CMT license which will prevent her from working in long term care facilities in the future. During this five-year period, Henry will be supervised by the Division of Probation and Parole.
April 20, 2015; Pennsylvania Attorney General: 2 women charged with Medicaid fraud after investigations by Attorney General's Medicaid Fraud Control Section
HARRISBURG - Attorney General Kathleen G. Kane today announced criminal charges have been filed against two women accused of committing Medicaid fraud.
April 20, 2015; Tennessee Department of Finance and Administration: Two in Bradley Co. Charged With TennCare Fraud
NASHVILLE, Tenn. - Two people in Bradley County are charged in separate cases with TennCare fraud involving prescription drugs.
April 20, 2015; Tennessee Department of Finance and Administration: Davidson Co. Woman Charged With TennCare Fraud
NASHVILLE, Tenn. - A Davidson County woman is charged with TennCare fraud for selling prescription drugs paid for by TennCare.
April 17, 2015; Nevada Attorney General: Attorney General Laxalt Pursues Fraudulent Health Care Providers
Carson City, NV - Nevada Attorney General Adam Paul Laxalt announced that Tanya Troup, 43, of Las Vegas, was sentenced this week for submitting false Medicaid claims for behavioral health services that were not provided. Troup entered a guilty plea to one count of intentional failure to maintain adequate records, a gross misdemeanor. The fraud was committed between March and September 2012.
April 16, 2015; New Hampshire Attorney General: Settlement Reached with Jeffrey Gould d/b/a North Country Medi-Van
Attorney General Joseph A. Foster announces that the Medicaid Fraud Control Unit (MFCU) of the Department of Justice has reached a settlement with Jeffrey Gould d/b/a North Country Medi-Van to resolve allegations that Mr. Gould submitted claims to the Medicaid program for wheelchair van services between 2009 and 2013 without maintaining adequate records to support the claims. As part of the settlement in this matter, Mr. Gould will pay a total of $75,885 in restitution and investigative costs. Mr. Gould d/b/a North Country Medi-Van no longer provides Medicaid services.
April 15, 2015; Connecticut Attorney General: State Reaches Settlement with Second Defendant in Alleged Fraudulent Medicaid Billing Lawsuit
The state has reached a settlement with a Stamford dentist and 13 of his practices and management companies resolving fraud allegations and civil claims stemming from an illegal Medicaid billing scheme, Attorney General George Jepsen said today.
April 14, 2015; Tennessee Department of Finance and Administration: Know Co. Woman Charged With TennCare Doctor Shopping
NASHVILLE, Tenn. - A Knox County woman is charged with TennCare fraud in nearby Anderson County, stemming from prescription drug fraud. The Office of Inspector General (OIG), with the assistance of the Anderson County Sheriff's Office, today announced the arrest of Cathy E. Moore, 46, of Oak Ridge. She was indicted by an Anderson County Grand Jury on eight counts of fraudulently using TennCare to obtain controlled substances by doctor shopping; and, eight counts of obtaining a controlled substance by fraud. Moore used TennCare benefits to pay for the clinical visits.
April 14, 2015; Tennessee Department of Finance and Administration: Rutherford Co. Woman Charged With TennCare Fraud
NASHVILLE, Tenn. - A Rutherford County woman is charged with TennCare fraud involving doctor shopping, a crime involving the use of TennCare benefits to obtain controlled substances by visiting multiple doctors in a short period of time.
April 9, 2015; Louisiana Attorney General: Attorney General Buddy Caldwell announces four arrests for Medicaid Fraud
In Attorney General Buddy Caldwell's ongoing effort to crack down on Medicaid fraud, four personal care attendants have been arrested this week and charged with defrauding the state's Medicaid program by causing the submission of false claims for payment of services.
April 9, 2015; Tennessee Department of Finance and Administration: Coffee Co. Woman Charged With TennCare Fraud
NASHVILLE, Tenn. - A Coffee County woman is charged with TennCare fraud in connection with selling prescription drugs which were paid for by the state's healthcare insurance program.
April 8, 2015; Tennessee Department of Finance and Administration: Fentress Co. Man Surrenders After 10 Months
The Office of Inspector General (OIG), with the assistance of the Fentress County Sheriff's Office, today announced the arrest of Jesse Reed Jones, 38, of Jamestown.
April 8, 2015; Alaska Department of Law: Mat-Su Activity and Respite Center Owner Laura Sasseen Sentenced to 120 Days in Jail for Altering Medical Records
The Alaska Department of Law, Medicaid Fraud Control Unit (MFCU) announced today the sentencing of 58 year old Laura Sasseen for altering medical records. Sasseen was the owner of the Mat-Su Activity and Respite Center (MARC) in Palmer, Alaska. Sasseen was charged for falsely altering medical records that were requested as part of an audit being conducted by the Department of Health and Social Services (DHSS).
April 7, 2015; Tennessee Department of Finance and Administration: Grainger Co. Man Charged With TennCare Fraud
NASHVILLE, Tenn. - A Grainger County man is charged with TennCare fraud involving prescription drugs. The Office of Inspector General (OIG) today announced the arrest of Christopher Seal, 28, of Sneedville. He was indicted by a Grainger County Grand Jury and charged with altering a legitimate prescription for the drug Suboxone by changing the quantity, then using TennCare benefits to pay for the forgery. Suboxone is a drug used to treat addiction to drugs such as morphine or heroin because it creates a similar affect without addictive qualities. Seal is charged with TennCare fraud and forgery. The Bean Station Police Department and the Hancock County Sheriff's Office assisted in his arrest.
April 6, 2015; Pennsylvania Attorney General: Three charged with Medicaid fraud by Attorney General Kane's Medicaid Fraud Control Section
HARRISBURG - Attorney General Kathleen G. Kane today announced criminal charges have been filed against three individuals accused of committing Medicaid fraud.
April 3, 2015; New York Attorney General: A.G. Schneiderman Announces Jail Sentence For EMT Who Stole From Queens Volunteer Ambulance Corps
NEW YORK - Attorney General Eric T. Schneiderman today announced that Daniel Dominguez, a volunteer emergency medical technician who stole over $300,000 from the Corona Community Volunteer Ambulance Corps (CCAC) in Queens, has been sentenced to serve four months in jail and five years probation, and to pay full restitution. In the event that Dominguez fails to pay the full restitution amount, he faces up to seven years in prison.
April 2, 2015; Nevada Attorney General: Attorney General Laxalt Announces Sentencing of Behavioral Health Provider for Medicaid Fraud
Carson City, NV - Nevada Attorney General Adam Paul Laxalt announced that Erik Badgett, 49, of Vista, CA was sentenced this week for his scheme of submitting false Medicaid claims for behavioral health services that were never provided. Badgett previously entered a guilty plea to one count of submission of false Medicaid claims and one count of theft. The fraud was committed between September 2011 and August 2013.
April 2, 2015; Louisiana Attorney General: Houma Personal Care Business Owner Charged with Defrauding Medicaid Program
The owner of a Houma personal care business has been arrested after Medicaid fraud agents uncovered she engaged in numerous schemes aimed at defrauding the state's Medicaid program, Attorney General Buddy Caldwell announced.
April 2, 2015; New York Attorney General: A.G. Schneiderman Announces Arrest Of Aide Accused Of Assaulting Queens Nursing Home Resident
NEW YORK - Attorney General Eric T. Schneiderman today announced the arrest of certified nurse aide Marie Jeanty on felony charges that she assaulted an 80-year-old, bedridden resident of West Lawrence Care Center, a nursing home located at 1410 Seagirt Boulevard in Far Rockaway, N.Y. If convicted on the top count, the defendant faces up to seven years in state prison.
April 2, 2015; Tennessee Department of Finance and Administration: Wilson Co. Woman Convicted of TennCare Fraud
NASHVILLE, Tenn. - A Wilson County woman will be sentenced in July after being found guilty of TennCare fraud and theft of services. Wanda June Williams, 53, of Mt. Juliet was arrested in September of 2013 after an indictment accusing her of falsely reporting her resources in order to appear eligible for the state's healthcare insurance program. During the two-day trial in Wilson County, it was revealed she had received healthcare benefits she was not entitled to amounting to $22,644.00.
April 1, 2015; Tennessee Department of Finance and Administration: Sumner, Perry Co. Residents Charged With TennCare Fraud
NASHVILLE, Tenn. - Two people are charged with TennCare fraud in separate cases in Perry and Sumner Counties, with both involving prescription drugs.
April 1, 2015; New York Attorney General: A.G. Schneiderman Announces Agreement With Fishkill Nonprofit Serving New Yorkers With Disabilities To Repay Medicaid $363,000 For Using Unqualified Staff
PEARL RIVER - Attorney General Eric T. Schneiderman today announced an agreement with Keli House Community Services, Inc., a Fishkill-based nonprofit serving New Yorkers with disabilities and their families, that used unqualified individuals to provide services to Medicaid recipients who participated in the Home and Community Based Services Program offered by the New York State Office of Persons with Developmental Disabilities (OPWDD). The settlement calls for Keli House to reimburse Medicaid $363,643.

March 2015

March 31, 2015; Brooklyn District Attorney; Kings County, N.Y.: Twenty-Three Defendants - Including Nine Doctors - Charged With Enterprise Corruption in Massive $7 Million Medicaid Fraud
Brooklyn District Attorney Ken Thompson, together with United States Health and Human Services Office of the Inspector General New York region Special Agent in Charge Scott J. Lampert, New York City Human Resources Administration Commissioner Steven Banks and the New York State Acting Medicaid Inspector General Dennis Rosen, today announced that nine doctors are among 23 defendants named in a 199-count indictment that alleges they participated in a massive scheme in which they lured people recruited from low-income neighborhoods, homeless shelters and welfare offices to corrupt medical clinics for unnecessary tests with the promise of free footwear such as sneakers, shoes and boots.
March 31, 2015; Florida Attorney General: Jackson County Man Arrested for Aggravated Abuse of Developmentally Disabled Patient
TALLAHASSEE, Fla.-Attorney General Pam Bondi's Medicaid Fraud Control Unit and the Jackson County Sheriff's Office today arrested a former employee of Sunland Center, in Marianna, Fla., for aggravated abuse of a disabled adult. While employed at Sunland, an intermediate care facility for the developmentally disabled, Justin Holmes, 20, antagonized a wheelchair bound resident to charge his wheelchair into Holmes. According to the investigation, Holmes then reacted by throwing the resident out of his wheelchair and onto the floor. As a result of the altercation, the resident sustained a broken neck.
March 30, 2015; Kentucky Attorney General: Attorney General Conway announces Guilty Plea and Sentencing of Whitley County Dentist Ronald Hungerbuhler for Medicaid Fraud
FRANKFORT, Ky. (March 30, 2015) - Attorney General Jack Conway and his Office of Medicaid Fraud today announce the guilty plea and sentencing of a Whitley County, Ky Dentist Ronald Hungerbuhler in Whitley Circuit Court.
March 30, 2015; Pennsylvania Attorney General: Attorney General Kane: Four accused of stealing $39K in separate Medicaid fraud schemes
HARRISBURG - Attorney General Kathleen G. Kane today announced criminal charges have been filed against four individuals accused of committing Medicaid fraud.
March 25, 2015; Delaware Attorney General: Milton Woman Pleads Guilty to Health Care Fraud
Karen Fueyo, 51, of Milton, a former employee of a licensed clinical social worker, pled guilty to one count of felony health care fraud, one count of felony theft and one count of felony conspiracy in the second degree in Sussex County Superior Court. She was sentenced by Judge E. Scott Bradley to three years of incarceration suspended for probation, and ordered to pay full restitution to the Delaware Medicaid Program, in addition to fines and court costs, as well as costs of investigation to the Department of Justice Medicaid Fraud Control Unit.
March 27, 2015; Louisiana Attorney General: Medicaid Fraud Control Unit Arrests Two
Two women have been arrested this week on Medicaid fraud charges after illegally billing the Louisiana Medicaid Program for health-care services that were not performed, Attorney General Buddy Caldwell announced today.
March 26, 2015; New York Attorney General: A.G. Schneiderman Announces Arrest Of Nurse For Stealing Narcotics From Nursing Home
PEARL RIVER - Attorney General Eric T. Schneiderman today announced the arrest of Terri Stephens-Traverse for allegedly stealing several pills containing oxycodone from an Orange County nursing facility's emergency pain medication supply. Stephens-Traverse was formerly employed at Campbell Hall Rehabilitation Center located in Campbell Hall, a hamlet in the Town of Hamptonburgh in Orange County.
March 26, 2015; Tennessee Department of Finance and Administration: Bedford Co. Man Charged With TennCare Drug Fraud
NASHVILLE, Tenn. - A Bedford County man is charged with TennCare fraud involving doctor shopping, or using TennCare to go to multiple providers to obtain controlled substances.
March 26, 2015; Tennessee Department of Finance and Administration: Alabama Man Charged With TennCare Fraud
NASHVILLE, Tenn. - An Alabama man is charged with claiming that he and his family lived in Tennessee in order to obtain TennCare healthcare benefits. The arrest came a year after the indictment was handed down.
March 26, 2015; Tennessee Department of Finance and Administration: Rhea Co. Man Charged 2nd Time With TennCare Fraud
NASHVILLE, Tenn. - A Rhea County man is charged a second time with TennCare fraud involving prescription drugs.
March 25, 2015; Mississippi Attorney General: Former Madison County Resident Arrested For Medicaid Fraud
A former Madison County resident has been arrested following indictment for Medicaid Fraud and Mail/Wire Fraud, announced Attorney General Jim Hood today.
March 25, 2015; Florida Attorney General: Leon County Woman Arrested for Abuse of Disabled Patient
TALLAHASSEE, Fla.-Attorney General Pam Bondi's Medicaid Fraud Control Unit today arrested a former Florida State Hospital employee, Arlesia Richardson, 50, for abuse of a disabled adult. Acting on a referral by Adult Protective Services, a division of the Department of Children and Family Services, MFCU investigators discovered that Richardson provoked a disabled adult resident, with a history of self-injurious behavior, into hitting his head against a door multiple times. Richardson is no longer employed at the Florida State Hospital.
March 20, 2015; Florida Attorney General: Four Arrested in Medicaid Fraud Scheme that Exploited the Homeless
TALLAHASSEE, Fla.-Attorney General Pam Bondi's Medicaid Fraud Control Unit announced the arrests of four individuals for allegedly recruiting the homeless to bilk Medicaid out of at least $215,000. According to the investigation, Christina Benson, owner of Tranquility Healthcare Solutions in Orlando, billed Medicaid for services for homeless men and women who were recruited by her associates to pose as patients. Tranquility Healthcare Solutions allegedly billed Medicaid for services not provided and services not warranted. The company also allegedly used personnel who were not trained, including some who had criminal arrest records.
March 19, 2015; New York Attorney General: A.G. Schneiderman Announces Arrest Of Former Not-For-Profit Director For Defrauding Medicaid And Stealing From A Developmentally Disabled Individual
GREENWICH- Attorney General Eric T. Schneiderman today announced the arrest and arraignment of Suzanne Shumway, former Executive Director of Battenkill Community Services, Inc. (BCS), a not-for-profit agency servicing developmentally disabled individuals, for allegedly defrauding Medicaid for services rendered to BCS consumers and theft of funds of a developmentally disabled person under her care. If convicted, she could face 1 1/3 to 4 years in prison.
March 19, 2015; Tennessee Department of Finance and Administration: Hamilton Co. Woman Charged 3rd Time With TennCare Fraud
NASHVILLE, Tenn. - A Hamilton County woman is charged a third time with "doctor shopping," which is the criminal use of TennCare benefits to obtain controlled substances.
March 18, 2015; Louisiana Attorney General: Attorney General's Office Arrests Tangipahoa Parish Woman on Medicaid Fraud Charges
A Tangipahoa Parish woman accused of illegally billing the Louisiana Medicaid Program for services she did not provide has been arrested for felony Medicaid Fraud, Attorney General Buddy Caldwell announced today.
March 18, 2015; Oklahoma Attorney General: AG Pruitt Announces Guilty Plea in Medicaid Fraud Prosecution of Mental Health Care Facility Operator
OKLAHOMA CITY - The operator of an Oklahoma mental health care facility pleaded guilty Wednesday to seven felony counts related to Medicaid fraud following charges brought by Attorney General Scott Pruitt's Medicaid Fraud Control Unit.
March 18, 2015; Michigan Attorney General: Schuette Files Felony Charges Against Employees of Detroit Medical Practice
LANSING - Attorney General Bill Schuette today announced felony charges against Dr. Murtaza Hussain, 51, of Livonia and three unlicensed Southeast Michigan employees with Livernois Family Medical Services, P.C. for their role in an elaborate Medicaid fraud scheme. The charges were filed following an investigation launched by Schuette's Health Care Fraud Division after a complaint was referred by the Inspector General for the Department of Community Health (DCH)
March 18, 2015; New York Attorney General: A.G. Schneiderman Announces Indictment Of Nonprofit Narco Freedom And Its Top Executives For Participating In An Organized Crime Ring
NEW YORK - Attorney General Eric T. Schneiderman today announced the arrest and indictment of the top four executives of the charity Narco Freedom Inc., including its present and former chief executive officers, its controller, and a son of the former chief executive for allegedly participating in a criminal enterprise. Narco Freedom, a Bronx-based nonprofit that provides substance abuse treatment and other services to thousands of New York City residents at ten locations, was also indicted.
March 18, 2015; New York Attorney General: A.G. Schneiderman Announces Settlement With Excellus Health Plan To End Wrongful Denial Of Mental Health And Addiction
NEW YORK - Attorney General Eric T. Schneiderman today announced the fifth settlement since last year in an unprecedented enforcement effort of mental health parity laws. The settlement, reached with Rochester-based Excellus Health Plan, requires the health insurer to cover residential treatment for behavioral health conditions and reform its procedures for evaluating behavioral health treatment claims. The settlement also requires Excellus to provide notice of a new appeal right to 3,300 members whose requests for inpatient substance use disorder rehabilitation and eating disorder residential treatment Excellus denied from 2011 through 2014. The estimated value of Excellus's denial of these individuals' requests is up to $9 million.
March 16, 2015; New York Attorney General: A.G. Schneiderman Announces Kickback Settlement With Pharma Manufacturer Daiichi-Sankyo
NEW YORK - Attorney General Eric T. Schneiderman today announced that New York, along with 49 other states and the District of Columbia have reached a settlement with Daiichi Sankyo, Inc. (Daiichi), a global pharmaceutical company with US headquarters in New Jersey. The settlement resolves allegations that Daiichi violated the False Claims Act by using lavish meals and speaker programs to improperly induce physicians to prescribe the drugs Azor, Benicar, Tribenzor and Welchol. Under the agreement, Daiichi agrees to pay the United States and the state Medicaid programs 39 million dollars, 10 million dollars to the state Medicaid Programs and 19 million to other Federal programs. Under this agreement, the New York State Medicaid program will receive $2,339,671.
March 13, 2015; Tennessee Department of Finance and Administration: McMinn Co. Woman Apprehended After 2014 Indictment for TennCare Fraud
NASHVILLE, Tenn. - A McMinn County woman has been arrested months after her indictment on charges of TennCare doctor shopping.
March 13, 2015; Tennessee Department of Finance and Administration: Knox Co. Man Charged 2nd Time with TennCare Fraud
NASHVILLE, Tenn. - A Knox County man is charged a second time with doctor shopping for drugs, which involves going to several doctors in a short period of time to obtain prescription drugs, using TennCare as payment.
March 12, 2015; Pennsylvania Attorney General: Mother charged with abusing special needs son, conspiring with boyfriend to commit Medicaid fraud
HARRISBURG - Attorney General Kathleen G. Kane today announced Medicaid fraud charges against a caregiver and his girlfriend for using her special needs son to commit Medicaid fraud. The mother also faces an aggravated assault charge for allegedly submerging her son's hand in liquid hot enough to cause a severe burn.
March 12, 2015; Louisiana Attorney General: East Carroll Parish Woman Arrested on Medicaid Fraud Charges
Attorney General Buddy Caldwell announced today that agents from the Attorney General's Medicaid Fraud Control Unit have arrested an East Carroll Parish health care worker for felony Medicaid fraud.
March 12, 2015; Florida Attorney General: Tip to MFCU Hotline Results in Restitution to Florida Medicaid
TALLAHASSEE, Fla.-Attorney General Pam Bondi today announced the plea of a Gadsden County Home Health Care Provider, Melissa Simmons, for defrauding the Florida Medicaid program out of more than $13,000. After receiving an anonymous tip through the Florida Medicaid Fraud Hotline, the Attorney General's Medicaid Fraud Control Unit began an investigation that revealed Simmons conspiring with two Leon County residents in billing Medicaid for services Simmons never rendered to a developmentally disabled child. The conspirators allegedly caused more than $13,000 in fraudulent claims to the Florida Medicaid program.
March 11, 2015; Georgia Attorney General: Gwinnett Couple Pleads Guilty to Stealing $1.4 Million from Georgia Medicaid
On March 6, 2015, Olufemi Afuape and Oluyemisi Afuape of Lilburn, Ga., pled guilty to one count of Medicaid Fraud (O.C.G.A. § 49-4-146.1(b)(1)) and one count of Conspiracy to Defraud the State (O.C.G.A. § 16-10-21(a)). Oluyemisi Afuape was sentenced to three years house arrest, followed by 12 years of probation. Olufemi Afuape was sentenced to three years work release at the Gwinnett Detention Center, followed by 12 years of probation. They were ordered to pay $1,407,325.50 in restitution to the Georgia Department of Community Health.
March 10, 2015; Kentucky Attorney General: Attorney General Conway Announces Guilty Plea in Medicaid Fraud Case
Attorney General Jack Conway and his Medicaid Fraud and Abuse Control Unit announce the guilty plea and sentencing of Hailey Smith in Hopkins District Court on a charge of defrauding the Kentucky Medicaid Program.
March 10, 2015; New York Attorney General: A.G. Schneiderman And I.G. Scott Announce The Guilty Plea Of An Oneida County Individual Who Engaged In Scheme To Defraud Medical
UTICA - Attorney General Eric T. Schneiderman and Inspector General Catherine Leahy Scott today announced the guilty plea of Jonathan Bronson, 39, of Westernville, NY, for having engaged in a lengthy scheme to defraud numerous medical care providers from August 1, 2010, through February 11, 2015. Mr. Bronson pleaded guilty to one count of Scheme to Defraud in the First Degree, a Class E felony, for which he has been promised a sentence of six months of incarceration and five years of probation.
March 6, 2015; Florida Attorney General: Three Men Arrested for $11 Million Multi-State Drug Diversion Scheme
TALLAHASSEE, Fla.-Attorney General Pam Bondi today announced the arrest of three men for their alleged involvement in a multi-state drug diversion ring. According to the investigation, the defendants orchestrated the purchase of millions of dollars of medications on the black market, primarily from Medicaid recipients in Miami, Fla. and Newark, N.J., and resold to pharmacies in the Northeast, including North Philly Pharmacy in Philadelphia, Pa. and Lu Puja Pharmacy in Chicago, Ill. The drugs included anti-depressants, anti-psychotics and HIV medications, such as Abilify, Atripla, Viread, Zyprexa and Plavix. The defendants allegedly operated out of locations in Houston, Texas, Orlando, Fla. and San Juan, Puerto Rico.
March 5, 2015; New York Attorney General: A.G. Schneiderman Announces Sentencing Of Former Office Manager For Stealing $11,828 From Residents Of An Assited Living Facility
ROCHESTER - Attorney General Eric T. Schneiderman today announced the sentencing of Rebecca Russell, former office manager of the Armstrong Senior Living Center in Newark, for crimes committed against three residents.
March 5, 2015; New York Attorney General: A.G. Schneiderman Announces Settlement With ValueOptions To End Wrongful Denial Of Mental Health And Substance Abuse Treatment Services
NEW YORK - Attorney General Eric T. Schneiderman today announced a settlement with Beacon Health Options (formerly known as ValueOptions) requiring the managed care company - which administers behavioral health benefits for approximately 2.7 million New Yorkers in fully funded or state and local government health plans - to dramatically reform its claims review process and pay a $900,000 penalty.
March 4, 2015; Tennessee Department of Finance and Administration: Madison Co. Couple Charged With TennCare Fraud
NASHVILLE, Tenn. - A husband and wife from Madison County are charged with TennCare fraud for not disclosing full information in order to gain healthcare insurance benefits from the state program.
March 4, 2015; Maryland Attorney General: AG Frosh Recoups Funds from Autism Services Provider that Improperly Billed Medicaid
Baltimore, MD (March 4, 2015) - Attorney General Brian E. Frosh announced today that an autism services provider with offices in Rockville and Towson has agreed to pay $58,000 to resolve claims that it billed the state Medicaid program for services it never delivered. The Office of the Attorney General's Medicaid Fraud Control Unit launched an investigation into Children Achieving Maximum Potential, Inc., (ChAMP) in 2010, after receiving a tip from a former employee.
March 3, 2015; Nevada Attorney General: Attorney General Laxalt Announces Sentencing of Medical Equipment Provider
Las Vegas, NV - Nevada Attorney General Adam Paul Laxalt announced that Oluwole Adegboruwa, 45, of Las Vegas, was sentenced this week for submitting false Medicaid claims for delivery of medical supplies. A jury found him guilty of felony and gross misdemeanor offenses of false Medicaid claims, theft, intentionally inadequate records and unlawful use of another's personal identification. The fraud occurred between October 2008 and December 2009.
March 3, 2015; Florida Attorney General: Alachua County Home and Community Based Service Provider Arrested for More Than $65,000 in Medicaid Fraud
TALLAHASSEE, Fla.-Attorney General Pam Bondi's Medicaid Fraud Control Unit and the Alachua County Sheriff's Office today arrested Christopher A. Days, 43, for more than $65,000 in Medicaid fraud. Days, the owner of Better Days of North Central Florida, LLC., allegedly defrauded the Florida Medicaid program by overbilling, billing for services not rendered and failing to properly document for services rendered for several Medicaid recipients.
March 3, 2015; Tennessee Department of Finance and Administration: Hamblen Co. Woman Charged with TennCare Drug Fraud
NASHVILLE, Tenn. - A Hamblen County woman is charged with TennCare drug fraud in nearby Cocke County. This arrest brings the total number of people arrested for TennCare fraud to 2,300 since the Office of Inspector General (OIG) began investigating and pursuing this criminal activity.

February 2015

February 26, 2015; Louisiana Attorney General: AG's Office Arrests Baker Couple for Medicaid Fraud
A Baker husband and wife have been arrested for conspiring to defraud the state's Medicaid program of more than $400,000, announced Louisiana Attorney General Buddy Caldwell.
February 26, 2015; Tennessee Department of Finance and Administration: Sumner Co. Woman Charged With TennCare Drug Fraud
NASHVILLE, Tenn. - A Sumner County woman is charged with TennCare fraud for selling prescription drugs that were paid for by the state's healthcare insurance plan.
February 23, 2015; Tennessee Department of Finance and Administration: Davidson Co. Woman Charged with TennCare Fraud
NASHVILLE, Tenn. - A Davidson County woman is charged with TennCare fraud after receiving healthcare benefits through the state's healthcare insurance, even though she was not eligible for benefits.
February 20, 2015; Nevada Attorney General: Attorney General Laxalt Announces Sentencing of Medicaid Provider
Las Vegas, NV - Nevada Attorney General Adam Paul Laxalt announced that Shana Wickersham, 38, of Las Vegas, was sentenced this week in a Medicaid fraud case. Justice Court Judge Deborah Lippis sentenced Wickersham for one misdemeanor offense of submitting false Medicaid claims. The fraud occurred between October 2012 and April 2014. As part of the sentence, Judge Lippis ordered the payment of $30,000 in restitution, penalties and costs.
February 20, 2015; Tennessee Department of Finance and Administration: Monroe Co. Woman Charged With TennCare Drug Fraud in Monroe, McMinn Counties
NASHVILLE, Tenn. - A Monroe County woman is charged in both McMinn and Monroe 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 19, 2015; Tennessee Department of Finance and Administration: Two in West Tennessee Charged With TennCare Fraud
NASHVILLE, Tenn. - Two people in West Tennessee are charged with TennCare fraud involving prescription drugs, including a man charged with the crime for the third time.
February 19, 2015; Florida Attorney General: Alachua County Personal Care Assistant Arrested for Abuse of a Disabled Adult
TALLAHASSEE, Fla.- Attorney General Pam Bondi's Medicaid Fraud Control Unit and the Alachua County Sheriff's Office today announced the arrest of a Personal Care Assistant for abuse of a disabled adult. According to the investigation, Marcus Bernard Woods, 52, inflicted physical injury on an assisted living facility resident while employed as a Personal Care Assistant at CoWorkers, Inc.
February 19, 2015; Pennsylvania Attorney General: Hazleton woman charged with Medicaid fraud
HARRISBURG - Attorney General Kathleen G. Kane today announced the arrest of a Hazleton woman for Medicaid fraud and theft for allegedly submitting false information about attendant care services she did not provide.
February 19, 2015; Tennessee Department of Finance and Administration: Dyer, Lauderdale co. Residents Charged with TennCare Fraud
NASHVILLE, Tenn. -Residents of Dyer and Lauderdale County are charged in separate cases involving TennCare fraud, both involving prescription drugs. The Office of Inspector General (OIG) today announced the arrests.
February 18, 2015; Missouri Attorney General: AG Koster announces Medicaid fraud settlement with St. Louis personal healthcare provider
Jefferson City, Mo. - Attorney General Chris Koster announced today that his office has reached a settlement with DEW D Services, LLC, of St. Louis, for submitting false claims to Missouri's Medicaid program. Under the settlement, the in-home healthcare provider will pay more than $150,000 in restitution, penalties, and investigation costs.
February 17, 2013; New York Attorney General: A.G. Schneiderman Announces Arrest Of Capital Region Nursing Home Aide Over Injury To 83 Year Old Resident
ALBANY - Attorney General Eric T. Schneiderman today announced the arrest and arraignment of Courtney Allen, a Certified Nurse Assistant (C.N.A.) from Glens Falls. Allen is facing charges that she endangered the welfare of a nursing home resident at The Stanton Nursing and Rehabilitation Center in Queensbury by failing to provide appropriate care to an 83 year old woman, resulting in the resident fracturing her hip.
February 17, 2015; New Jersey Attorney General: Former Home Health Aide Pleads Guilty to Charges He Stole More Than $64,000 from Medicaid by Submitting Phony Claims
TRENTON - Acting Attorney General John J. Hoffman and the Office of the Insurance Fraud Prosecutor (OIFP) announced that a former employee of a home health agency today pleaded guilty to charges that he caused bills to be submitted to the Medicaid program for services that were never provided.
February 13, 2015; Maryland Attorney General: AG Frosh: Bladensburg Man Indicted for Medicaid Fraud, Theft and Neglect of a Vulnerable Adult
Baltimore, MD (Feb. 13, 2015) - Attorney General Brian E. Frosh announced today that Paul Anthony Robb, 53, of Bladensburg, was indicted by the Grand Jury for Montgomery County on two counts of Felony Medicaid Fraud, three counts of Felony Theft and two counts of Second Degree Neglect of a Vulnerable Adult. Robb allegedly defrauded the Maryland Medicaid program between January 2011 and November 2013.
February 12, 2015; Florida Attorney General: Palm Beach County Health Care Provider Arrested for More Than $5,000 in Medicaid Fraud
TALLAHASSEE, Fla.- Attorney General Pam Bondi's Medicaid Fraud Control Unit and the Palm Beach County Sheriff's Office today arrested Lakeshia Lashawn Ramsay, 31, for more than $5,000 in Medicaid fraud. While employed as a direct care contractor at Superior Family Services, located in Delray Beach, Ramsay allegedly submitted fraudulent time sheets and progress reports for respite care services that were never rendered, resulting in false Medicaid claims. Based on a complaint by the owner of Superior Family Services, the investigation revealed that the defendant claimed 465 hours of respite care service when in reality she performed 13 hours of service.
February 12, 2015; Tennessee Department of Finance and Administration: Putnam Co. Woman Charged With TennCare Doctor Shopping
NASHVILLE, Tenn. - A Putnam County woman is charged with TennCare fraud involving doctor shopping, which is the crime of going to multiple doctors in a short period of time to obtain prescription drugs, using TennCare as payment.
February 11, 2015; Oklahoma Attorney General: AG Pruitt Charges Two Texans with Medicaid Fraud
OKLAHOMA CITY - Oklahoma Attorney General Scott Pruitt filed charges against Orlando Glenn Rayfield, of Arlington, Texas and Trevor Allan Gordon, Jr., of Grand Prairie, Texas for the billing of therapy sessions that never occurred.
February 11, 2015; Tennessee Department of Finance and Administration: Sevier co. Man 2nd Time With TennCare Doctor Shopping
NASHVILLE, Tenn. - A Sevier County man is charged a second time with doctor shopping for drugs, using TennCare as payment.
February 10, 2015; Tennessee Department of Finance and Administration: Know co. Man Charged with TennCare Drug Fraud
NASHVILLE, Tenn. - A Knox County man is charged with TennCare fraud in nearby Jefferson County in connection with prescription drug fraud.
February 10, 2015; Nevada Attorney General: Attorney General Laxalt Announces Sentencing of Medicaid Provider for Submitting False Medicaid Claims
Las Vegas, NV - Nevada Attorney General Adam Paul Laxalt announced that Victor Sutton, 41, of Las Vegas, NV was sentenced today for a felony offense in a Medicaid fraud case for submitting false Medicaid claims. His sentence also included a gross misdemeanor offense of intentional failure to maintain adequate records.
February 10, 2015; Tennessee Department of Finance and Administration: LAWRENCE CO. MAN CHARGED WITH 21 COUNTS OF TENNCARE FRAUD
NASHVILLE, Tenn. - A Lawrence County man is charged with 21 counts of TennCare fraud involving doctor shopping, which is using TennCare to go to multiple healthcare providers in a short time period to obtain controlled substances.
February 9, 2015; Kansas Attorney General: Kansas City woman sentenced to prison, restitution for home health care fraud
KANSAS CITY, Kan. - (February 9, 2015) - A Kansas City, Kan., woman working as a personal care attendant was sentenced in U.S. District Court last week for health care fraud based on fraudulent bills she submitted to Medicaid, U.S. Attorney Barry Grissom and Kansas Attorney General Derek Schmidt announced.
February 9, 2015; Maryland Attorney General: AG Frosh: Randallstown Man Convicted of Felony Medicaid Fraud
Baltimore, MD (Feb. 9, 2015) - Attorney General Brian E. Frosh announced today that Roy Onyeka 27, of Randallstown, pleaded guilty on February 4 to Felony Medicaid Fraud. Baltimore County Circuit Court Judge Kathleen Gallogly Cox sentenced Onyeka to 18 months in jail, with all but 9 days suspended for time already served. Judge Cox also placed Onyeka on probation for 3 years, ordered him to pay restitution of $3,147.29 and civil damages of the same amount to the Medicaid program. He must also perform 50 hours of community service.
February 6, 2015; Pennsylvania Attorney General: Phila. mother, son, daughter charged with Medicaid fraud
HARRISBURG - Attorney General Kane today announced Medicaid fraud and other charges against two siblings for defrauding Medicaid by $35,000 as care attendants for their disabled mother, who also was part of the scheme.
February 5, 2015; Pennsylvania Attorney General: Attorney General Kane: Psychiatrist committed Medicaid Fraud, treatment offenses in two counties
HARRISBURG- Attorney General Kathleen G. Kane today announced the arrest of Dr. Jopinda Pal Harika, 61, Red Oak Court, Monroeville, Allegheny County, for practicing and writing prescriptions on a suspended license as a contractor at mental health facilities in Philadelphia and Berks counties.
February 5, 2015; Louisiana Attorney General: Bossier City Woman Arrested for Stealing From Elderly Medicaid Patient
A Bossier City woman has been arrested for stealing more than $42,000 from an elderly Louisiana Medicaid recipient, announced Attorney General Buddy Caldwell.
February 5, 2015; Tennessee Department of Finance and Administration: KNOX CO. WOMAN CHARGED WITH 10 COUNTS OF TENNCARE FRAUD
NASHVILLE, Tenn. - A Knox County woman is charged with TennCare fraud involving doctor shopping for prescription drugs, using TennCare healthcare insurance benefits as payment.
February 4, 2015: New York Attorney General: A.G. Schneiderman Announces Arrest Of Westchester Nonprofit Executive In Scheme Involving State Program To Assist Seniors And The Disabled
PEARL RIVER - Attorney General Eric T. Schneiderman today announced the arrest of Darlington Odidika, 47, of Poughkeepsie, the Executive Director of Systems and Abilities, Inc., a Yonkers-based nonprofit that specialized in securing state-funded service contracts that provided construction and moving services to the elderly and disabled to allow them to move from nursing homes back into the community. Odidika and Systems and Abilities, Inc. were charged with rigging contractors' bids, demanding kickbacks from sub-contractors and defrauding Medicaid of more than $50,000.
February 4, 2015; Pennsylvania Attorney General: Attorney General Kane announces charges in $1 million Medicaid fraud scheme
HARRISBURG - Attorney General Kathleen G. Kane and the Office of Inspector General of the U.S. Department of Health & Human Services today announced Medicaid fraud and other charges against Philadelphia-based Infinite Care Inc., sister company Infinite Care Special Needs Inc., and the companies' vice president and treasurer.
February 3, 2015; Attorney General of New York: A.G. Schneiderman Announces Arrest And Guilty Plea Of Erie County Nurse Aide For Taking And Exchanging Compromising Photograph Of Incontinenet Patient Via Snapchat
NEW YORK - Attorney General Eric T. Schneiderman today announced the arrest of Edward J. Melock, a nurse aide in Erie County, for taking and exchanging a compromising photograph of an incontinent patient via the smartphone app Snapchat. Melock, who was employed at Greenfield Health and Rehabilitation Center in Lancaster, was accused of taking the photograph of an elderly patient in a state of undress on or about March 1, 2013, and sharing it via Snapchat.
February 2, 2015; Tennessee Department of Finance and Administration: HAMILTON CO. WOMAN CHARGED 2ND TIME WITH TENNCARE FRAUD
NASHVILLE, Tenn. - A Hamilton County woman faces TennCare fraud charges a second time, after her arrest a month ago.
February 2, 2015; Tennessee Department of Finance and Administration: TWO IN SUMNER CO. CHARGED WITH TENNCARE FRAUD; WOMAN CHARGED THIRD TIME
NASHVILLE, Tenn. - Two Sumner County residents are charged with TennCare fraud involving prescription drugs, including a woman charged for the third time with doctor shopping.
February 2, 2015; Tennessee Department of Finance and Administration: KNOX CO. WOMAN CHARGED 2ND TIME WITH TENNCARE FRAUD
NASHVILLE, Tenn. - A Knox County woman is charged for a second time with doctor shopping for controlled substances, using TennCare benefits as payment.

January 2015

January 30, 2015; Missouri Attorney General: AG Koster announces Medicaid fraud settlement that will return $29,000 to Missouri Medicaid
Jefferson City, Mo. -- Attorney General Chris Koster today announced a settlement with B & D Adult Daycare, LLC, of St. Louis County, and its owner-operator, Bryan Sanders, Sr. The agreement requires Sanders and his company to pay $29,000 to the state's Medicaid program.
January 30, 2015; Missouri Attorney General: AG Koster announces settlement with Cape Girardeau Medicaid provider
Jefferson City, Mo. - Attorney General Chris Koster announced today that his office reached a settlement with Jennifer Kirchhoff, a Cape Girardeau counselor, for allegedly submitting false claims to Missouri's Medicaid program, MO HealthNet. As required by the settlement agreement, Kirchhoff has paid the state $25,000.
January 29, 2015; Missouri Attorney General: AG Koster announces judgment against St. Louis County woman for Medicaid fraud
Jefferson City, Mo. - Attorney General Chris Koster announced today that a consent judgment against Loretta Baskin, 53, of St. Louis County, for submitting false claims to Missouri's Medicaid program.
January 29, 2015; Tennessee Department of Finance and Administration: TWO MID-STATE RESIDENTS CHARGED WITH TENNCARE FRAUD
NASHVILLE, Tenn. - Residents of Giles and Coffee Counties are charged with TennCare fraud in separate cases, both involving prescription drugs.
January 29, 2015; Tennessee Department of Finance and Administration: KNOX CO. MAN CHARGED WITH TENNCARE DRUG FRAUD
NASHVILLE, Tenn. - A Knox County man is charged with TennCare fraud involving doctor shopping, which involves using the state healthcare program benefits to obtain prescriptions for controlled substances.
January 28, 2015; Alabama Attorney General: AG Announces Indictment Of Bessemer PHARMACIST FOR MEDICAID FRAUD, THEFT OF OVER $50,000 FROM MEDICAID AGENCY
(MONTGOMERY)--Attorney General Luther Strange announced the arrest of Alan Bruce Connell, 68, a Bessemer pharmacist and former owner of Westlake Pharmacy in Bessemer, on four counts of filing false claims with the Alabama Medicaid Agency and one count of first-degree theft of property. - See more at:http://www.ago.state.al.us/News-589#sthash.VGak3U5c.dpuf
January 28, 2015; Tennessee Department of Finance and Administration: Knox Co. Woman Charged With TennCare Drug Fraud
NASHVILLE, Tenn. - A Knox County woman is charged with TennCare fraud involving doctor shopping, which is the crime of using public dollars through TennCare benefits to obtain multiple prescriptions for controlled substances.
January 27, 2015; Tennessee Department of Finance and Administration: Hardeman Co. Man Charged With TennCare Drug Fraud
NASHVILLE, Tenn. - A Hardeman County is charged with TennCare fraud involving doctor shopping, or using TennCare to go to multiple doctors in a short time period to obtain controlled substances.
January 26, 2015; Tennessee Department of Finance and Administration: Hamilton Co. Woman Charged With TennCare Drug Fraud
NASHVILLE, Tenn. - A Hamilton County woman is charged with TennCare fraud in Rhea County, in charges accusing her of doctor shopping for prescription drugs, using TennCare as payment.
January 26, 2015; Tennessee Department of Finance and Administration: Obion Co. Man Convicted of TennCare Fraud, Must Repay State
NASHVILLE, Tenn. - An Obion County man charged in McNairy County with falsely reporting his income in order to qualify for TennCare has been sentenced to repay the state for healthcare insurance benefits he received during the time he was on the program.
January 21, 2015; Louisiana Attorney General: Guilty Verdict Obtained in $7 Million Medicaid Fraud Case
A south Louisiana personal care agency, its owner and his wife were each found guilty for their roles in a scheme aimed at creating forged CPR certifications and submitting false documentation to the Louisiana Department of Health and Hospitals (DHH) in order to fraudulently bill the state's Medicaid program more than $7 million, announced Attorney General Buddy Caldwell.
January 21, 2015; 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 the sale of prescription drugs paid for by the state's health care insurance program.
January 20, 2015; Tennessee Department of Finance and Administration: Giles Co. Woman Charged With TennCare Fraud in Two Separate Counties
NASHVILLE, Tenn. - A Giles County woman is charged with TennCare fraud in cases in two counties in Middle Tennessee. Both cases involve prescription drug fraud.
January 20, 2015; Florida Attorney General: Six Arrested in Leon County for More Than $170,000 in Medicaid Fraud
TALLAHASSEE, Fla.-Attorney General Pam Bondi's Medicaid Fraud Control Unit, with the assistance from the Tallahassee Police Department and the Leon County Sheriff's Office, arrested six former Targeted Case Managers of DS Connections, Inc. for more than $170,000 in Medicaid fraud. DS Connections is a targeted case management company headquartered in Winter Park, Fla. with offices in Clermont and Tallahassee.
January 15, 2015; Kentucky Attorney General: AG Conway Announces Arraignment of Powell County Woman on Exploitation Charge
FRANKFORT, Ky. - Attorney General Jack Conway and his Medicaid Fraud and Abuse Control Unit today announced the arraignment of a Powell County woman on one count of knowing exploitation of an adult over $300. Bobbie Creech, 30, was indicted by a Clark County grand jury on Dec. 11, 2014, and arrested on Jan. 9, 2015. She was arraigned this morning in Clark Circuit Court.
January 13, 2015; Missouri Attorney General: AG Koster announces Medicaid fraud settlement to return $50,000 to Missouri Medicaid program
Jefferson City, Mo. - Attorney General Chris Koster announced today that he has reached a settlement with Victor's Home Care Services, LLC, of St. Louis, for submitting false claims to MO HealthNet, Missouri's Medicaid program. The agreement required Victor's to pay $50,000 to the state's Medicaid fraud reimbursement fund.
January 13, 2015; New Jersey Department of Law and Public Safety: Former Home Health Aide Admits to Falsely Billing Medicaid 178 Times
TRENTON - Acting Attorney General John J. Hoffman and the Office of the Insurance Fraud Prosecutor (OIFP) announced that a former employee of a home health agency yesterday pleaded guilty to charges that he caused bills to be submitted to the Medicaid program for services that were never provided.
January 13, 2015; Tennessee Department of Finance and Administration: Unicoi Co. Man Charged with TennCare Drug Fraud
NASHVILLE, Tenn. - A Unicoi County man is charged with TennCare fraud for selling Hydrocodone paid for by TennCare.
January 12, 2014; New York Attorney General: A.G. Schneiderman Announces Settlement With Health Insurer Over Excessive Copays For Customers In Rochester Area
NEW YORK - Attorney General Eric T. Schneiderman today announced an agreement with Excellus Health Plan, Inc. requiring that its contracted health care providers issue refunds to thousands of members in New York State for charging excessive copays. The Attorney General's investigation revealed that Excellus issued incorrect Explanations of Benefits, which imposed an additional specialty co-payment for member visits to a primary care provider.
January 12, 2014; Tennessee Department of Finance and Administration: Hardin Co. Woman Charged 2nd Time with TennCare Fraud
NASHVILLE, Tenn. - A Hardin County woman is charged for the second time with doctor shopping, a crime involving fraudulent efforts to obtain prescription drugs through TennCare benefits.
January 9, 2015; Tennessee Department of Finance and Administration: Knox Co. Man Charged with TennCare Drug Fraud
NASHVILLE, Tenn. - A Knox County man is charged with doctor shopping for prescription drugs, using TennCare as payment for the pills.
January 9, 2015; Tennessee Department of Finance and Administration: Perry Co. Woman Charged with TennCare Drug Fraud
NASHVILLE, Tenn. - A Perry County woman is charged with TennCare fraud in connection with selling prescription drugs which were paid for by the state's Medicaid healthcare insurance program.
January 8, 2015; Virginia Attorney General: Provider of Home Health Care Services and Spouse Sentenced for Medicaid Fraud
NORFOLK, Va. -W. Wayne Perry, Jr., 56, and his wife Angela Perry, 52, formerly of Suffolk, Virginia, were sentenced today for charges including health care fraud, false statements relating to health care matters, alteration of records and aggravated identity theft to W. Wayne Perry, Jr. was sentenced to 63 months in prison, followed by three years of supervised release. Angela Perry was sentenced today to 25 months in prison, followed by three years of supervised release. In addition, together they are to pay $1,459.451.08 in restitution.
January 8, 2015; New York Attorney General: A.G. Schneiderman Announces Arrest Of Dentist In Medicaid Theft
NEW YORK - Attorney General Eric T. Schneiderman today announced the arrest of a Manhattan dentist for filing false claims and stealing $11,479 from Medicaid. Howard Rothenberg, 64, of West Nyack, NY, allegedly claimed to have provided services to patients he never met or who he treated only in prior years. The defendant is a licensed, practicing dentist with an office located at 205 East 111th Street in Manhattan.
January 5, 2015; Colorado Attorney General: Colorado Attorney General Announces $22 Million Settlement with DaVita Regarding Illegal Kickbacks
DENVER-Colorado Attorney General John Suthers today announced five states have reached a $22 million settlement with DaVita Healthcare Partners, Inc., of which Colorado will recover more than $3 million. The settlement resolves allegations that between 2008 and 2013, DaVita entered into a number of transactions with physicians and/or physician groups in which the company would buy or sell shares in dialysis clinics at prices that were manipulated to make the transactions financially attractive for the physicians and generate patient referrals to its dialysis centers.
January 5, 2015; New York Attorney General: A.G. Schneiderman Announces $300k Settlement With Queens-Based Transportation Provider
NEW YORK - Attorney General Eric T. Schneiderman today announced that Apple Transportation of New York, Inc., a Queens-based transportation company, will pay $300,000 to settle claims that it overbilled Medicaid for transportation services.
January 5, 2015; Tennessee Department of Finance and Administration: Two in Memphis Charged in Cases Involving TennCare Fraud, Prescription Drugs
NASHVILLE, Tenn. - Two people in Memphis are charged in separate cases involving TennCare fraud and prescription drugs.

December 2014

December 22, 2014; New Jersey Attorney General: Former Home Health Aide Admits to Falsely Billing Medicaid for Medical Services in No-Show Scam
TRENTON - Acting Attorney General John J. Hoffman and the Office of the Insurance Fraud Prosecutor (OIFP) announced that a former employee of a home health agency pleaded guilty on December 19 to charges that he caused bills to be submitted to the Medicaid program for services that were never provided.
December 22, 2014; Florida Attorney General: Jefferson County Certified Nursing Assistant Arrested for Stealing Hyrdrocodone from Patient
TALLAHASSEE, Fla.-Attorney General Pam Bondi's Medicaid Fraud Control Unit and the Jefferson County Sheriff's Office today arrested Cathy Flint, 55, for allegedly stealing hydrocodone from a patient while employed as a Certified Nursing Assistant at Byrnwood Center in Jefferson County. Flint is facing charges of grand theft of a controlled substance, a third degree felony, and faces up to five years in prison and fines. The Office of the State Attorney for the Second Judicial Circuit will prosecute the case.
December 19, 2014; Tennessee Department of Finance and Administration: Mississippi Woman Must Repay State After TennCare Fraud Conviction
NASHVILLE, Tenn. - Two women from Mississippi must repay TennCare for medical benefits received when they were on the program after they were convicted of fraud.
December 18, 2014; Florida Attorney General: Broward County Nursing Home Admissions Director Arrested for Grand Theft and Exploitation of an Elderly Person
TALLAHASSEE, Fla.- Attorney General Pam Bondi today announced that a Ft. Lauderdale woman is in custody for exploitation of an elderly person. Attorney General Bondi's Medicaid Fraud Control Unit and the Boca Raton Police Department arrested Cathy Hanna, 42, for allegedly having a 79-year-old nursing home resident with dementia withdraw money from her account to give to Hanna and pay Hanna's car payment. The total amount exploited from the victim was $12,000.
December 18, 2014; Arkansas Attorney General: Pulaski County Woman Sentenced to 10 Years in Prison for Medicaid Fraud
LITTLE ROCK - A Pulaski County woman accused of improperly billing the state's Medicaid program pleaded no contest today to felony Medicaid fraud and failure to maintain records, Attorney General Dustin McDaniel announced.
December 17, 2014; New York Attorney General: A.G. Schneiderman Announces Arrest Of Aide Accused Of Endangering Suffolk Nursing Home Resident
HAUPPAUGE - Attorney General Eric T. Schneiderman today announced the arrest of Claudia Desulme, a certified nurse aide, on charges she endangered the welfare of a 92-year-old, wheelchair-bound resident of Huntington Hills Center for Health and Rehabilitation in Melville, N.Y. Court documents filed in the case allege Desulme illegally moved the resident from her wheelchair to her bed without the assistance of another staff person, as required by the resident's care plan and that, as a result, the resident sustained a laceration to her right leg. In an attempt to cover up the illegal transfer, Desulme, and another uncharged aide, allegedly bandaged the wound and failed to report the injury. Desulme, who no longer works at the facility, faces multiple felony and misdemeanor charges and up to four years in prison.
December 17, 2014; Wisconsin Department of Justice: Lake Geneva Woman Charged with Medicaid Fraud
MADISON - Attorney General J.B. Van Hollen announced today that a Lake Geneva woman has been charged with three counts of medical assistance fraud. According to the Department of Justice's criminal complaint, Linda J. Turner, R.N., Lake Geneva, is a certified Wisconsin Medicaid provider providing private duty nursing services since June 14, 1995. Wisconsin Medicaid is a program jointly funded by the state and federal governments that pays for health-related services to low-income and medically needy persons.
December 16, 2014; Arkansas Attorney General: Attorney General Announces Two Medicaid Fraud Arrests
LITTLE ROCK - Attorney General Dustin McDaniel announced today that health-care workers from Pulaski and Phillips counties have been arrested following two separate investigations by the Attorney General's Medicaid Fraud Control Unit.
December 15, 2014; Tennessee Department of Finance and Administration: Dickson Co. Woman Charged With TennCare Fraud
NASHVILLE, Tenn. - A Dickson County woman is charged with fraudulently obtaining TennCare benefits by falsely claiming she had dependent children in the home in order to qualify for the state's healthcare insurance program.
December 15, 2014; Tennessee Department of Finance and Administration: Dyer Co. Man Charged 2nd Time With TennCare Fraud
NASHVILLE, Tenn. - A Dyer County man is charged a second time this month for "doctor shopping," or going to multiple doctors in a short period to obtain the same or similar controlled substances.
December 15, 2014; Tennessee Department of Finance and Administration: Six Arrested in Dyer co. on TennCare Drug Fraud Charges
NASHVILLE, Tenn. - TennCare fraud charges are lodged against six people after a Dyer County Grand Jury issued indictments based on evidence from the Office of Inspector (OIG) and the Dyersburg Police Department. The charges involve the resale of prescription drugs paid for with TennCare benefits and doctor shopping.
December 12, 2014; Missouri Attorney General: AG Koster charges Kansas City woman with felony Medicaid fraud
Jefferson City, Mo. - Attorney General Chris Koster said today that Ame Riggs, 47, of Kansas City, has been criminally charged with one felony count of Medicaid fraud and one felony count of stealing by deceit. Riggs is alleged to have falsified documents to indicate she arranged for and received in-home personal care services through Medicaid's Consumer Directed Services program that were never actually provided, using payments received for her personal use.
December 12, 2014; Tennessee Department of Finance and Administration: Bledsoe Co. Woman Charged with TennCare Doctor Shopping
NASHVILLE, Tenn. - A Bledsoe County woman is charged in an indictment with TennCare fraud involving "doctor shopping," which is going from doctor to doctor in a short period of time in order to obtain prescription drugs, using TennCare as payment.
December 11, 2014; Indiana Attorney General: Warrant search today at pain clinic locations in Seymour, Jeffersonville
SEYMOUR, Ind. - Today investigators conducted warrant searches at the offices of The Pain Medicine and Rehabilitation Center located at 357 Tanger Blvd. Suite 201B Seymour, Ind., and 1730 Williamsburg Dr., Suite 4, Jeffersonville, Ind., and collected records as part of an ongoing investigation into possible overprescribing of prescription painkillers to patients, as well as Medicaid fraud and insurance fraud as outlined in an affidavit.
December 11, 2014; New York Attorney General: A.G. Schneiderman Announces Settlement With Manhattan Doctor's Office For Alleged Deceptive Business Practices
NEW YORK - Attorney General Schneiderman today announced an agreement with PATH Medical, P.C., that requires the Manhattan-based business to ensure patients receive accurate information about their financial responsibility before undergoing medical testing and other services. The settlement with PATH Medical, located at 304 Park Avenue South and owned by Dr. Eric Braverman, the host of a weekly radio program that often promotes his business, concludes an investigation by the Attorney General's Health Care Bureau that alleged PATH Medical misrepresented to patients how much of the cost a health insurer was likely to cover, including for the extensive testing PATH Medical routinely conducted on new patients.
December 9, 2014; Tennessee Department of Finance and Administration: Three People in DeKalb County Charged With TennCare Fraud
NASHVILLE, Tenn. - A husband and wife along with another woman are charged in DeKalb County with TennCare fraud involving prescription drugs.
December 9, 2014; Arkansas Attorney General: Attorney General Announces Three Medicaid Fraud Arrests
LITTLE ROCK - Attorney General Dustin McDaniel announced today that health-care workers in Benton County, Craighead County and Mississippi County have been arrested following three separate investigations by the Attorney General's Medicaid Fraud Control Unit.
December 10, 2014; Florida Attorney General: Four Miami-Dade County Residents Arrested for More Than $196,000 in Medicaid Fraud
TALLAHASSEE, Fla.-Attorney General Pam Bondi's Medicaid Fraud Control Unit and the Miami-Dade Police Department today arrested Luz Alvelo, 40, Maria Fernanda-Flores, 24, Manuel Otero, 42, and Yaniel Leal, 36, for more than $196,000 in Medicaid fraud. The defendants allegedly paid Medicaid recipients kickbacks of $20 per day to receive psychosocial rehabilitative services and then submitted falsified claims for targeted case management services that were not rendered to Medicaid recipients.
December 10, 2014; New York Attorney General: A.G. Schneiderman Announces Arrest Of Nurse Accused Of Striking Elderly Resident In Dutchess County Nursing Home
PEARL RIVER - Attorney General Eric T. Schneiderman today announced the arrest of Maria Fernandez, a licensed practical nurse, for allegedly slapping an 83-year-old, wheelchair-bound resident in the dining hall of Victory Lake Nursing Center in the Town of Hyde Park. Fernandez, who no longer works at the facility, faces a felony endangerment charge, and up to four years in prison, after the interaction was caught on a surveillance camera. The resident, whose identity is being kept confidential, suffers from dementia and other ailments that rendered her totally dependent on others for care.
December 10, 2014; New York Attorney General: A.G. Schneiderman Announces Settlement With Unlicensed Syracuse Adult Care Facility
SYRACUSE - Attorney General Eric T. Schneiderman today announced that his office has reached a settlement with The Inn at Menorah Park, located at 4101 East Genesee Street in Syracuse. The settlement resolves an investigation which found that The Inn had been operating as an unlicensed adult care facility. Adult care facilities may not operate without first obtaining an operating certificate from the New York State Department of Health.
December 9, 2014; Tennessee Department of Finance and Administration: Perry Co. Man Charged with TennCare Drug Fraud
NASHVILLE, Tenn. - A Perry County man is charged with TennCare fraud in connection with selling prescription drugs paid for by the state's healthcare insurance program.
December 9, 2014; Tennessee Department of Finance and Administration: Decatur Co. Woman Pleads Guilty to TennCare Fraud
NASHVILLE, Tenn. - A Decatur County woman must repay Tennessee for healthcare services paid for by TennCare, after pleading guilty to TennCare fraud.
December 8, 2014; Arkansas Attorney General: Crittenden County Woman Pleads Guilty to Medicaid Fraud
LITTLE ROCK -A Crittenden County woman accused of improperly billing the state's Medicaid program pleaded guilty today to felony Medicaid fraud, Attorney General Dustin McDaniel announced.
December 4, 2014; Washington Attorney General: Attorney General Ferguson files Medicaid Fraud Lawsuit Against School Consultant
OLYMPIA - The Attorney General's Medicaid Fraud Control Unit filed a lawsuit today against a Wenatchee-based company that allegedly provided fraudulent training to dozens of school districts around the state, leading to tens of millions of dollars in false Medicaid claims.
December 4, 2014; Tennessee Department of Finance and Administration: Warren Co. Woman Charged with TennCare Fraud
NASHVILLE, Tenn. - A Warren County woman is charged with TennCare fraud for using the state's healthcare insurance program to pay for fraudulent prescriptions.
December 4, 2014; Tennessee Department of Finance and Administration: Two Charged with TennCare Fraud in Humphreys Co. Indictments
NASHVILLE, Tenn. - Two mid-state residents are charged with TennCare fraud in separate indictments from Humphreys County. Both cases involve prescription drugs.
December 4, 2014; Tennessee Department of Finance and Administration: Bradley Co. Woman Charged with TennCare Drug Fraud
NASHVILLE, Tenn. - A Bradley County woman is charged with TennCare fraud for using the state's healthcare insurance program to pay for fraudulent prescriptions, as well as doctor shopping for drugs.
December 3, 2014; Tennessee Department of Finance and Administration: Two Charged with TennCare Fraud in Macon, Maury Counties
NASHVILLE, Tenn. - Two people are charged in separate TennCare fraud cases in Macon and Maury Counties, with both involving prescription drugs.
December 1, 2014; Alaska Department of Law: 1.2 Million Dollars in Restitution Ordered in Medicaid Case against Good Faith Services
The State of Alaska, Department of Law, Medicaid Fraud Control Unit (MFCU) announced today that Good Faith Services, LLC (Good Faith) entered a plea of guilty to a single count of Medical Assistance Fraud on Friday, November 28, 2014.
December 1, 2014; Tennessee Department of Finance and Administration: Gibson County Woman Charged with TennCare Doctor Shopping
NASHVILLE, Tenn. - A Gibson County woman is charged with doctor shopping for drugs, using TennCare as payment.
December 1, 2014; Tennessee Department of Finance and Administration: Hamblen Co. Woman Convicted of TennCare Fraud
NASHVILLE, Tenn. - A Hamblen County woman accused of falsely reporting her income in order to obtain TennCare benefits has been ordered to serve six years and repay the state for services.
December 1, 2014; Idaho Attorney General: Attorney General Reaches Settlement with Four Rexburg Physicians
(Boise) - Attorney General Lawrence Wasden has reached settlements with four Rexburg physicians investigated for refusing to provide on-call coverage for the emergency department of their local hospital.
December 1, 2014; Tennessee Department of Finance and Administration: Sumner Co. Woman Charged with TennCare Doctor Shopping
NASHVILLE, Tenn. - A Sumner County woman is charged with TennCare fraud involving doctor shopping, or using TennCare to go to multiple doctors in a short time period to obtain prescriptions for a controlled substance. The Office of Inspector General (OIG), with assistance from the Sumner County Sheriff's Office, today announced the arrest of Amanda Preston, 35, of Portland. She is charged with six counts of fraudulently using TennCare to obtain a controlled substance by doctor shopping and five counts of obtaining a controlled substance by fraud in connection with obtaining prescriptions for the painkiller Hydrocodone.
December 1, 2014; Tennessee Department of Finance and Administration: Hickman Co. Woman Charged with TennCare Drug Fraud
NASHVILLE, Tenn. - A Hickman County woman is charged in with TennCare fraud in Dickson County. The Office of Inspector General (OIG) today announced the arrest of Missy Brooks Coleman, 34, of Nunnely, after a joint investigation with the 23rd Judicial District Drug Task Force.

November 2014

November 26, 2014; South Dakota Attorney General: Avera Gregory Hospital Settles with State on Improper Medicaid Claims
PIERRE, S.D - Attorney General Marty Jackley and Avera Gregory Hospital announced today that they have reached a settlement involving Medicaid payments. According to the settlement agreement, the State contends that Avera Gregory Hospital submitted allegedly improper claims to Medicaid involving coding errors during the approximate time period from January 1, 2005, through April 30, 2014. The settlement is neither an admission of liability by Avera Gregory Hospital, nor a concession by South Dakota that its claims are not well founded.
November 25, 2014; Maryland Attorney General: Randallstown Man Indicted for Medicaid Fraud, Identity Fraud, and Theft
Baltimore, MD (Nov. 25, 2014) - Attorney General Douglas F. Gansler announced today that Roy Onyeka, age 27, of Randallstown, was indicted by the Grand Jury for Baltimore County on two counts of Felony Medicaid Fraud, one count of Identity Fraud, and one count of Felony Theft-Scheme. Court dates in this case have yet to be scheduled.
November 25, 2014; Kansas Attorney General: AG Schmidt, Federal Authorities Crack Down on Home Health Care Fraud in Kansas
TOPEKA - (November 25, 2014) - Kansas Attorney General Derek Schmidt and the U.S. Department of Health and Human Services/Office of Inspector General have joined forces to crack down on home health care fraud in Kansas and have obtained their first criminal conviction from the joint operation, both offices announced today.
November 25, 2014; Florida Attorney General: Okeechobee Woman Arrested for More Than $34,000 in Medicaid Fraud
TALLAHASSEE, Fla.-Attorney General Pam Bondi's Medicaid Fraud Control Unit and the Okeechobee County Sheriff's Office arrested Nancy Zeigler, 53, for more than $34,000 in Medicaid fraud. According to the investigation, Ziegler fraudulently billed Medicaid for services never provided while employed as the Executive Director at Okeechobee Rehabilitation Facility, Inc. Ziegler allegedly billed Medicaid for adult day care, transportation and respite care that amounted to more than $34,000. Zeigler is charged with one count of Medicaid fraud, a second-degree felony. If convicted, she faces up to 15 years in prison, a fine of more than $170,000, and restitution. The Attorney General's Office of Statewide Prosecution is prosecuting this case.
November 24, 2014; New York Attorney General: A.G. Schneiderman Announces Indictment Of Three Brooklyn Pharmacies, Pharmacy Owners, And Pharmacists For Alleged $5 Million Medicaid Fraud
NEW YORK - Attorney General Eric T. Schneiderman today announced the indictment of three pharmacies and seven individuals for allegedly defrauding Medicaid of over $5 million. The pharmacies were allegedly paying customers for prescriptions obtained from a local doctor and then billed Medicaid for the drugs even though they were never dispensed.
November 21, 2014; Tennessee Department of Finance and Administration: Second Round of TennCare Fraud Charges for Franklin Co. Woman
NASHVILLE - A Franklin County woman is charged for the second time with doctor shopping or going to multiple doctors in order to obtain controlled substances.
November 21, 2014; Tennessee Department of Finance and Administration: Franklin Co. Woman Charged with TennCare Doctor Shopping
NASHVILLE, Tenn. - A Franklin County woman is charged with TennCare fraud involving doctor shopping, or using TennCare healthcare insurance to go to multiple doctors in a short time period to obtain controlled substances.
November 18, 2014; Missouri Attorney General: AG Koster Announces Medicaid Fraud Settlement with Home-Care Provider
Jefferson City, Mo. - Attorney General Chris Koster announced today that he has reached a settlement with Independent Home Care, Inc., of St. Louis, and the company's owner, Sharlene Scruggs, for submitting false claims to MO HealthNet, Missouri's Medicaid program. The agreement requires Scruggs and her business to pay the state $224,616
November 17, 2014; Tennessee Department of Finance and Administration: Mother, Daughter in Unicoi Co. Charged with TennCare Fraud
NASHVILLE, Tenn. - A mother and daughter from Unicoi County are accused of selling drugs that were obtained using TennCare, the state's healthcare insurance program.
November 17, 2014; Georgia Attorney General: Atlanta OB/GYN Convicted of Medicaid Fraud Ordered to Repay $300,000 in Stolen Medicaid Funds
On November 13, 2014, Judge Christopher S. Brasher of the Fulton County Superior Court ordered convicted felon Nathaniel Johnson, of Atlanta, to repay the State of Georgia $300,000 in stolen Medicaid funds.
November 14, 2014; Wisconsin Department of Justice: Kenosha Business Owner Charged with Medicaid Fraud
MADISON - Attorney General J.B. Van Hollen announced today that a Kenosha woman has been charged with seven counts of medical assistance fraud, two counts of forgery and one count of racketeering activity. A preliminary hearing has been scheduled for December 16, 2014, at 9:30 am.
November 13, 2014; New York Attorney General: A.G. Schneiderman Secures Agreement With Finger Lakes Health Network Expanding Accommodations For The Deaf And Hard-of-Hearing
NEW YORK - Attorney General Eric T. Schneiderman today announced an agreement with the Finger Lakes Health network of hospitals and healthcare facilities to strengthen its policies concerning communication with patients and their family members or companions who are deaf or hard of hearing. The agreement will expand access to sign-language interpreters, as needed, and improve policies and training to ensure that medical staff members are able to effectively communicate with the deaf and hard of hearing.
November 10, 2014; Georgia Department of Law: Two Charged with Falsely Billing Georgia Medicaid for Over $977K
On Thursday, November 6, 2014, a Cobb County Grand Jury charged Matthew David Harrell and Andrea Lillie Barrett with one count of Medicaid Fraud (O.C.G.A. § 49-4-146.1(b)), one count of Conspiracy to Defraud the State (O.C.G.A. § 16-10-21), and one count each of Identity Fraud (O.C.G.A. § 16-9-121) for stealing over $977,000 from Georgia Medicaid.
November 10, 2014; Maryland Attorney General: AG Gansler: Silver Spring Man Indicted for Medicaid Fraud and Theft
Baltimore, MD (Nov. 10, 2014) - Attorney General Douglas F. Gansler announced today that Taba Eseme, 39, of Silver Spring, has been indicted by the Prince George's County Grand Jury on one count of felony Medicaid fraud and one count of felony theft scheme. Court dates have not yet been scheduled.
November 10, 2014; Tennessee Department of Finance and Administration: Sullivan Co. Sentenced to a Year in Jail for TennCare Fraud
NASHVILLE, Tenn. - A Sullivan County woman is sentenced to a year in prison, after pleading guilty to TennCare fraud involving prescription drugs.
November 10, 2014; Tennessee Department of Finance and Administration: Sumner Co. Man Charged a 2nd Time with TennCare Fraud
NASHVILLE, Tenn. - A Sumner County man is charged for the second time with TennCare fraud involving prescription drugs.
November 10, 2014; Tennessee Department of Finance and Administration: Tipton Co. Woman Charged with TennCare Doctor Shopping
NASHVILLE, Tenn. - A Tipton County woman has been indicted for TennCare fraud involving "doctor shopping," or using TennCare to pay for multiple provider visits in short time period to obtain controlled substances.
November 10, 2014; Tennessee Department of Finance and Administration: Marshall Co. Man Charged with TennCare Drug Fraud
NASHVILLE, Tenn. - A Marshall County man is charged with TennCare fraud involving prescription drugs. The Office of Inspector General (OIG), with the assistance from the Marshall County Sheriff's Office, today announced the arrest of 25-year old Justin L. King, of Lewisburg.
November 7, 2014; Florida Attorney General: Attorney General's Office Arrests Assisted Living Facility Administrator
TALLAHASSEE, Fla.-Attorney General Pam Bondi's Medicaid Fraud Control Unit today arrested an Escambia County assisted living facility administrator, 43-year-old Adrienne Taylor, for allegedly tampering with or harassing a witness, tampering with or fabricating physical evidence, and giving false information to a law enforcement officer. According to the investigation, Taylor withheld evidence, created false reports, and had others provide false statements during an investigation into her employer, Kipling Manor. Taylor could receive 31 years in prison and fines. The case will be prosecuted by the Office of the State Attorney, William "Bill" Eddins, in the First Judicial Circuit.
November 7, 2014; Arkansas Attorney General: Medicaid Fraud Arrests Announced
LITTLE ROCK - Attorney General Dustin McDaniel announced today that the executive director and case manager for a now-closed Faulkner County facility for the developmentally disabled have been arrested for Medicaid fraud and exploitation following an investigation by the Attorney General's Medicaid Fraud Control Unit.
November 6, 2014; Pennsylvania Attorney General: Attorney General Kane announces arrest of Philadelphia man for Medicaid fraud
HARRISBURG - Attorney General Kane today announced Medicaid fraud and other charges against a Philadelphia man for defrauding more than $82,000 by claiming to care for his brother when he was being cared for by a hospital, and after he died.
November 6, 2014; Tennessee Department of Finance and Administration: Knox Co. Woman Convicted of TennCare Fraud
NASHVILLE, Tenn. - A Knox County woman charged with fraudulently obtaining TennCare healthcare insurance benefits is ordered to pay for services received when she was on the program.
November 6, 2014; Tennessee Department of Finance and Administration: Decatur Co. Woman Charged with TennCare Fraud
NASHVILLE, Tenn. - A Decatur County woman is charged in Henderson County with fraudulently obtaining TennCare benefits by falsely claiming dependent children in order to qualify for TennCare benefits.
November 3, 2014; Idaho Attorney General: Duo Sentenced for Medicaid Fraud
(Boise) - Cline M. Waddell and his office manager, Linda J. Hefner, of Assisting Hands Home Care-Boise, LLC, a Nampa business, have been sentenced for defrauding Medicaid, Attorney General Lawrence Wasden said.
November 3, 2014; Nevada Attorney General: Attorney General Masto Announces an $8 Million Charitable Contribution as Part of a Settlement with Pfizer
Las Vegas, NV - Nevada Attorney General Catherine Cortez Masto announced today that her Office has reached a $9.5 million settlement with Pfizer Inc., to resolve the State's lawsuit that Pfizer and Wyeth Pharmaceuticals unlawfully promoted certain postmenopausal hormone therapy medications and misled Nevada consumers and physicians about the safety and efficacy of these drugs.
November 3, 2014; Mississippi Attorney General: Greenville Doctor Found Guilty of Medicaid Fraud
A Greenville doctor has been found guilty of defrauding the state's Medicaid fraud system, announced Attorney General Jim Hood today.
October 30, 2014; Florida Attorney General: Homestead Man Arrested for Battery on a Disabled Adult
TALLAHASSEE, Fla.-Attorney General Pam Bondi's Medicaid Fraud Control Unit and the Miami-Dade Police Department today arrested Carlos Cuzan, 44, for battery on a disabled adult. Acting on information from the Florida Department of Children and Families, the Attorney General's Medicaid Fraud Control Unit's Patient Abuse, Neglect and Exploitation (PANE) team investigated this case. According to the investigation, a co-worker witnessed Cuzan punching a victim several times in the face while employed as a medical health technician by the South Florida Evaluation and Treatment Center, a forensic hospital. The victim, who suffers from schizophrenia, was treated for a laceration to his lip.
October 30, 2014; Tennessee Department of Finance and Administration: Smith Co. Women Charged with TennCare Drug Fraud
NASHVILLE, Tenn. - Two women from Smith County are charged with TennCare fraud related to obtaining prescription drugs through TennCare insurance benefits, then selling a portion of the drugs.
October 28, 2014; Tennessee Department of Finance and Administration: Campbell Co. Woman Sentenced to TennCare Fraud Conviction
NASHVILLE, Tenn. - A Campbell County woman charged with TennCare fraud in Scott County is sentenced to probation and repaying the state for healthcare benefits received through the state's insurance program
October 28, 2014; Tennessee Department of Finance and Administration: Lincoln Co. Man Charged with Doctor Shopping for Drugs
NASHVILLE, Tenn. - A Lincoln County is charged with TennCare fraud involving doctor shopping, or using TennCare to go to multiple doctors in a short time period to obtain prescriptions for a controlled substance.
October 28, 2014; Tennessee Department of Finance and Administration: Knox Co. Woman Charged with TennCare Fraud for 3rd Time
NASHVILLE, Tenn. - A Knox County woman faces her third charge of using TennCare to "doctor shop" for prescription drugs.
October 24, 2014; Virginia Attorney General: Virginia Beach Man Indicted in Major Health Care Fraud of Virginia Medical Assistance Program
NORFOLK, Va. - Baffour E. Opoku, owner and operator of Progressive Counseling Services, LLC, a Virginia Beach based counseling business, and nine other current and former employees were indicted on Wednesday by a federal grand jury for their alleged roles in a scheme to defraud the Virginia Medical Assistance Program. Court documents were unsealed today.
October 23, 2014; Tennessee Department of Finance and Administration: Two in Sullivan Co. Charged with TennCare Fraud
NASHVILLE, Tenn. - Two people in Sullivan County are charged with TennCare fraud in separate cases. Tracy L. Hanifin, 43, of Kingsport, is charged with fraudulently obtaining prescription drugs by doctor shopping for controlled substances, using TennCare as payment. Jennifer Carter, 38, of Bristol, is charged with two counts of TennCare fraud and two counts of theft of services, in connection with fraudulently obtaining health care insurance benefits through TennCare.
October 23, 2014; Tennessee Department of Finance and Administration: Sevier County Man Charged with TennCare Fraud
NASHVILLE, Tenn. - A Sevier County man is charged in Hamblen County with TennCare fraud involving doctor shopping, or using the state's healthcare insurance program to obtain multiple prescriptions for drugs.
October 23, 2014; Florida Attorney General: Riviera Beach Behavior Support Assistant Arrested for Defrauding Medicaid Out of More Than $11,000
TALLAHASSEE, Fla.- Attorney General Pam Bondi's Medicaid Fraud Control Unit and the Palm Beach County Sheriff's Office today arrested Janese Jiles, 29, for allegedly defrauding the Florida Medicaid program out of more than $11,000. According to the investigation, Jiles submitted fraudulent claims for services never rendered while employed by Positive Behavior Supports Corporation, a Medicaid provider.
October 22, 2014; New York Attorney General: A.G. Schneiderman Announces Arrest And Indictment Of Nonprofit Executives Charged In Kickback And Insurance Fraud Schemes
NEW YORK - Attorney General Eric T. Schneiderman today announced the arrest and indictment of the top two executives of Narco Freedom, a nonprofit organization that provides treatment for substance abuse to tens of thousands of New York City residents at ten locations in Brooklyn, Queens and the Bronx. The organization's director, Alan Brand, allegedly received personal kickbacks for housing some of Narco Freedom's facilities in the buildings of a particular real estate developer. He then used the proceeds of these illegal dealings to fund a lavish lifestyle, according to today's indictment. Alan Brand has been charged with bribery, grand larceny and money laundering for this part of the alleged scheme; if convicted, he faces a maximum of 15 years in prison.
October 20, 2014; Tennessee Department of Finance & Administration: Jefferson Co. Man Charged with TennCare Drug Fraud
NASHVILLE, Tenn. - A Jefferson County man is charged with TennCare fraud for using the program to obtain prescription drugs which he later sold. The arrest brings the total number of people charged with TennCare fraud to 2,200, since the Office of Inspector General (OIG) began investigating and pursuing this criminal activity.
October 16, 2014; Texas Attorney General: Attorney General Abbott Recovers $39.75 Million for State of Texas, U.S. Medicaid Program
AUSTIN-Texas Attorney General Greg Abbott has resolved an enforcement action against Ranbaxy, a generic drug manufacturer. The agreement resolves the State's lawsuit under the Texas Medicaid Fraud Prevention Act ("TMFPA") against Ranbaxy Pharmaceuticals, Inc., Ranbaxy Laboratories, Inc., Ranbaxy USA, Inc. and Ranbaxy, Inc. for fraudulently reporting inflated drug prices to the Medicaid program.
October 16, 2014; Maryland Attorney General: AG Gansler: Baltimore County Caregiver Indicted for Neglect of Vulnerable Adults and Reckless Endangerment
Baltimore, MD (Oct. 16, 2014) - Attorney General Douglas F. Gansler announced today that Jamal Alin DeWitt, 29, of Baltimore, was indicted by the Baltimore County Grand Jury with six criminal counts arising out of an incident that occurred September 3, 2013 in the Cockeysville area. The indictment consisted of three counts of Neglect of a Vulnerable Adult in the Second Degree and three counts of Reckless Endangerment. Arraignment has been set for November 12 in the Baltimore County Circuit Court.
October 16, 2014; New Jersey Attorney General: Operation RayScam: Seven Medical Practitioners Arrested for Allegedly Taking Kickbacks in Exchange for Referrals to Medical Imaging Centers Owned by Criminal Enterprise
TRENTON - Acting Attorney General John Hoffman and the Office of the Insurance Fraud Prosecutor (OIFP) announced that seven medical practitioners were arrested yesterday for allegedly taking illegal kickbacks worth approximately $200,000 from Diagnostic Imaging Affiliates (DIA) in exchange for patient referrals to the company's testing facilities. In a span from 2008 to 2013, the doctors allegedly made more than 20,000 referrals to DIA centers, which resulted in payments of millions of dollars from private insurance carriers and the Medicare and Medicaid programs.
October 15, 2014; Tennessee Department of Finance and Administration: Rhea Co. Man Charged 2nd Time this Month with TennCare Fraud
NASHVILLE, Tenn. - A Rhea County man is charged for the second time this month with TennCare fraud involving "doctor shopping," or using TennCare to go to multiple doctors in a short time period to obtain controlled substances.
October 15, 2014; Tennessee Department of Finance and Administration: Putnam Co. Woman Charged 2nd Time with TennCare Doctor Shopping
NASHVILLE, Tenn. - A Putnam County woman is facing her second arrest "doctor shopping," or going to multiple doctors in a short time period to obtain the same or similar controlled substances and using TennCare healthcare insurance benefits as payment.
October 15, 2014; Idaho Attorney General: Idaho Settles Medicaid Fraud Case Against Organon USA Inc.
(Boise) - Attorney General Lawrence Wasden has reached a settlement agreement with Organon USA Inc., a New Jersey-based pharmaceutical company accused of misrepresenting the cost of its antidepressant drug and providing kickbacks to care providers.
October 15, 2014; New York Attorney General: A.G. Schneiderman Announces $31 Million National Medicaid Settlement With Pharmaceutical Company
NEW YORK - Attorney General Eric T. Schneiderman today announced that New York State has joined with other states and the federal government to settle allegations that drug manufacturer Organon underpaid rebates to New York State's Medicaid program, offered improper financial incentives to nursing home pharmacy companies, promoted its antidepressants for unapproved uses, and misrepresented its drug prices to New York's Medicaid program. Organon was headquartered in Oss, Netherlands, and the company's assets are now owned by Merck. The total value of the settlement is $31 million. As part of the settlement, New York will receive $2,489,999 in restitution and other recoveries.
October 15, 2014; Florida Attorney General: Florida Obtains More than $483,000 from Organon in National Settlement
TALLAHASSEE, Fla.-Attorney General Pam Bondi, 49 other attorneys general and the federal government reached a $31 million settlement with Organon, a drug manufacturing company, to settle allegations that the company underpaid rebates to the Florida Medicaid program, offered improper financial incentives to nursing home pharmacy companies, promoted its antidepressants for unapproved uses and misrepresented its drug prices. Organon's headquarters are in Oss, Netherlands, and the company's assets are now owned by Merck. Florida's net share of the total settlement amounts to more than $483,000.
October 15, 2014; Tennessee Department of Finance and Administration: Alabama Woman Charged with TennCare, Food Stamp
NASHVILLE, Tenn. - An Alabama woman is charged with TennCare fraud and food stamp fraud for falsely reporting her residency in order to obtain benefits from both taxpayer-funded programs.
October 15, 2014; Tennessee Department of Finance and Administration: Two in Knox Co. Charged With TennCare Drug Fraud
NASHVILLE, Tenn. - Two Knox County residents are charged with TennCare fraud in separate cases involving prescription drugs.
October 15, 2014; Tennessee Department of Finance and Administration: Williamson Co. Woman Charged with TennCare Drug Fraud
NASHVILLE, Tenn. - A Williamson County woman is charged with TennCare fraud for filling a fraudulent prescription and using TennCare healthcare insurance benefits to pay for it.
October 14, 2014; Tennessee Department of Finance and Administration: Two Charged with TennCare Drug Fraud in Hamblen Co. Investigation
NASHVILLE, Tenn. - Two people are charged with TennCare drug fraud after an undercover operation in Hamblen County.
October 13, 2014; Tennessee Department of Finance & Administration: Rhea Co. Man Charged with TennCare Doctor Shopping
NASHVILLE, Tenn. - A Rhea County man is charged in Morgan County with TennCare fraud involving doctor shopping, or using TennCare to go to multiple doctors in a short time period to obtain controlled substances.
October 13, 2014; Florida Attorney General: Three North Florida Women Arrested for $13,000 in Medicaid Fraud
TALLAHASSEE, Fla.-Attorney General Pam Bondi's Medicaid Fraud Control Unit, with the assistance of the Gadsden County Sheriff's Office and the Tallahassee Police Department, arrested a Gadsden County woman and two Tallahassee residents for Medicaid fraud. According to the investigation, Melissa L. Simmons, 39, conspired with Felicia S. Williams, 37, and Willie-Mae Williams, 64, to bill Medicaid for services Simmons, a home health care provider, never rendered to a developmentally disabled child causing more than $13,000 in fraudulent claims.
October 10, 2014; Pennsylvania Attorney General: Washington Co. pharmacy owner arrested for stealing $346,000 and diverting 33,000 prescription pills
HARRISBURG - Attorney General Kathleen G. Kane announced the arrest of a Washington County pharmacist and business owner on charges he submitted false prescription claims to insurance companies to steal more than $346,000, and diverted powerful prescription drugs to patients without proper prescriptions.
October 10, 2014; Texas Attorney General: Fort Worth Chiropractor Enters Guilty Plea In Health Care Fraud Case Investigated by State and Federal Officials
FORT WORTH - The owner/operator of a chiropractic clinic in Fort Worth, Texas, pleaded guilty this afternoon to a federal felony offense stemming from her submission of approximately $718,000 in false reimbursement claims to Medicare and Medicaid, announced U.S. Attorney Sarah R. Saldaña of the Northern District of Texas.
October 10, 2014; New Jersey Department of Law & Public Safety: Passaic County Home Health Aide Indicted for Submitting 3,797 Fraudulent Claims to Medicaid
TRENTON - Acting Attorney General John J. Hoffman and Office of the Insurance Fraud Prosecutor (OIFP) announced that a former certified home health aide from Passaic County was indicted on Wednesday for causing fraudulent claims totaling $87,616.23 to be submitted to the Medicaid program for work he never actually completed on behalf of his Hackensack-based employer Confident Care.
October 9, 2014; Pennsylvania Attorney General: Medicaid fraud: Philadelphia woman billed $72,000 by forging deceased attendant's signature
HARRISBURG - Attorney General Kathleen G. Kane today announced the arrest of a Philadelphia woman who allegedly fraudulently billed $72,000 to Medicaid for care from an attendant after he had died.
October 9, 2014; New York Attorney General: A.G. Schneiderman Announces $846,000 Settlement With New York Specialty Pharmacy To Resolve Allegations Of Medicaid Fraud
NEW YORK - Attorney General Eric T. Schneiderman today announced that the state has entered into a settlement agreement with Sorkin's Ltd Rx. d/b/a CareMed Pharmaceutical Services ("Sorkin's"), a New York-based retail specialty pharmacy, resolving allegations that it made false statements to the New York State Medicaid Program to secure expeditious prior authorizations for the coverage of specialty drugs, and that it submitted false claims to the New York State Medicaid Program for certain prescription medications that were restocked and resold and for refills that recipients never obtained.
October 9, 2014; Florida Attorney General: Port St. Lucie Woman Arrested for $19,000 in Medicaid Fraud
TALLAHASSEE, Fla.-Attorney General Pam Bondi's Medicaid Fraud Control Unit and the St. Lucie County Sheriff's Office have arrested Claudia Laurenceau, 43, for defrauding the Medicaid program. According to the investigation, Laurenceau was responsible for assisting developmentally disabled Medicaid recipients while serving as a Medicaid Waiver Support Coordinator. Laurenceau allegedly billed the Medicaid program more than $19,000 for services she did not provide. The Agency for Persons with Disabilities had discontinued Laurenceau as a Medicaid Waiver Support Coordinator in November 2013 due to failure to perform her duties.
October 8, 2014; Tennessee Department of Finance & Administration: Knox Co. Woman Charged with TennCare Doctor Shopping
NASHVILLE, Tenn. - A Knox County woman is charged in an indictment with TennCare fraud involving doctor shopping for controlled substances, using TennCare state healthcare insurance benefits as payment.
October 2, 2014; Florida Attorney General: Polk County Woman Arrested for Abuse of a Disabled Adult
TALLAHASSEE, Fla.—Attorney General Pam Bondi's Medicaid Fraud Control Unit and the Polk County Sheriff's Office today arrested Bonnie L. Coleman, a house manager at a Medicaid-funded group home in Winter Haven, for abusing a disabled adult.

September 2014

September 29, 2014; Washington Attorney General: Attorney General wins Medicaid fraud conviction over Wheelchairs Plus president
OLYMPIA - In a case brought by the Attorney General, the owner of a wheelchair company that fraudulently delivered 119 used or refurbished wheelchairs to the poor and disabled across the state was convicted on felony charges Sept. 25 in Thurston County Superior Court.
September 29, 2014; Florida Attorney General: Palm Beach County Man Sentenced For More Than $9,000 of Medicaid Fraud
TALLAHASSEE, Fla.-Attorney General Pam Bondi today announced that Judge Charles J. Roberts, Brevard Circuit Court, sentenced Richard Day to two years in prison, three years of probation, and $9,200 in restitution for Medicaid fraud. The case was prosecuted by Attorney General Pam Bondi's Office of Statewide Prosecution. While employed at MTS Health Services, LLC, a Brevard County nursing home, Day used a forged mental health counseling license causing more than $9,000 of fraudulent billing to the Medicaid program.
September 26, 2014; Kansas Attorney General: Emporia woman sentenced to more than 7 years for mistreatment of dependent adult
EMPORIA - (September 26, 2014) - An Emporia woman was sentenced today to more than seven years in prison for mistreatment of a dependent adult and conspiring to mistreat a dependent adult, Kansas Attorney General Derek Schmidt said.
September 25, 2014; Maryland Attorney General: AG Gansler: Medtronic, Inc. Settles Kickback Allegations for $9.9 Million
Baltimore, MD (Sept. 25, 2014) - Attorney General Douglas F. Gansler announced today that Maryland, joined by other states and the federal government, has settled allegations that Medtronic, Inc., paid kickbacks to health care practitioners to induce them to use its cardiac rhythm management devices, including pacemakers and defibrillators. In May, the Minnesota-based company paid the federal government approximately $9.6 million in civil damages for federal health care program damages. Medicaid programs nationwide will receive approximately $362,362 of the total settlement, of which $6,128.86 is attributable to Maryland.
September 25, 2014; Florida Attorney General: Florida Obtains More Than $900,000 from Shire Pharmaceuticals, LLC
TALLAHASSEE, Fla.-Attorney General Pam Bondi, 49 other attorneys general, and the federal government today reached a $56.5 million settlement with Shire Pharmaceuticals, LLC, a Pennsylvania based company, to resolve allegations that the company engaged in off-label marketing campaigns that improperly promoted five of its drugs: Adderrall XR, Vyvanse, Daytrona, Lialda and Pentasa. Adderrall XR, Vyvanse and Daytrona are United States Food and Drug Administration approved for treatment of Attention Deficit Hyperactivity Disorder, and Lialda and Pentasa are approved for treatment of mildly to moderately active ulcerative colitis. The Medicaid program will receive $48.1 million of the settlement to resolve civil allegations of false submitted claims to government health care programs. Florida's share of the total Medicaid settlement amounts to more than $900,000. The settlement is the first national settlement in which Medicaid managed care damages have been calculated and included as part of a recovery.
September 25, 2014; Florida Attorney General: Two Miami-Dade Women Arrested for Medicaid Fraud
TALLAHASSEE, Fla.-Attorney General Pam Bondi's Medicaid Fraud Control Unit and the Miami-Dade Police Department today arrested Mildred Lucia Madrid, 51, and Maritza Isabel Alvarez, 47, for allegedly defrauding the Florida Medicaid program out of more than $38,000. According to the investigation, Madrid and Alvarez falsified documents to Medicaid stating that Alvarez was the caregiver of Madrid's son and that Alvarez performed more hours of service than actually rendered. Madrid and Alvarez allegedly concealed the fact that they were sisters, which would prohibit payment to Alvarez.
September 25, 2014; Delaware Attorney General: Biden's Medicaid Fraud Control Unit secures $137,000 for Delaware in national false claims settlement with pharmaceutical company
Wilmington - Delaware Attorney General Beau Biden announced Thursday that Shire Pharmaceuticals will pay Delaware $137,000 as part of a national settlement with state and federal governments to resolve allegations that the company improperly marketed its drugs for off-label uses.
September 24, 2014; Florida Attorney General: Hialeah Man Arrested for Medicaid Fraud
TALLAHASSEE, Fla.-Attorney General Pam Bondi's Medicaid Fraud Control Unit arrested Alfonso Garcia, 50, for allegedly defrauding Medicaid out of more than $270,000. According to the investigation, Alfonso Garcia supplied Medicaid recipients' pharmaceuticals to a co-conspirator and was paid through Garcia's corporations by using fraudulent invoices to disguise the source of the income.
September 23, 2014; New York Attorney General: A.G. Schneiderman Announces Felony Arrest Of Long Island Psychiatrist On Charges Of Illegally Selling Prescriptions For Controlled Substances To Undercover Investigators
HAUPPAUGE - Attorney General Eric T. Schneiderman today announced the arrest of Nasreen Kader, a psychiatrist, on charges she unlawfully sold prescriptions for controlled substances in the course of her professional practice, without a legitimate medical purpose. The investigation was opened by the Attorney General's office after two Long Island families complained that Kader was over prescribing highly addictive controlled substances to their family members. The felony case lodged against the Suffolk County doctor charges that she repeatedly offered prescriptions for Xanax and Klonopin, powerful tranquilizers used to treat anxiety disorders, and Ritalin, a stimulant prescribed for concentration disorders including Attention Deficit Hyperactivity Disorder, to undercover Attorney General investigators posing as patients who sought the drugs for illegitimate purposes.
September 23, 2014; New York Attorney General: A.G. Schneiderman Announces Arrest Of Two Nursing Home Employees On Charges They Neglected Disabled Resident
BUFFALO - Attorney General Eric T. Schneiderman today announced the arrest of two employees of Erie County Medical Center Skilled Nursing Facility (now known as Terrace View Long Term Care Facility) in Buffalo, following an investigation into their treatment of a nursing home resident. The investigation, which relied on a hidden camera placed in the patient's room, revealed an alleged pattern of neglect. The two nursing assistants are charged with a variety of felony and misdemeanor counts in Buffalo City Court.
September 22, 2014; Alaska Department of Law: Mat-Su Activity and Respite Center and Its Owner Charged for Falsely Altering Medical Assistance Records
The Alaska Department of Law, Medicaid Fraud Control Unit (MFCU) announced today the filing of felony charges against the Mat-Su Activity and Respite Center, LLC (MARC) for falsely altering medical assistance records. The alterations, if undetected by auditors, would have resulted in the MARC retaining in excess of $287,000 in overpayments from the Alaska Medicaid Program.
September 18, 2014; Vermont Attorney General: Attorney General Obtains $73,500 Medicaid Recoupment From Michigan Drug Testing Company
A Michigan-based company will pay the State of Vermont in excess of $73,500 to settle claims that it obtained payments from the Vermont Medicaid Program to which it was not entitled, according to Vermont Attorney General William H. Sorrell. The provider, Physicians Toxicology, LLC offers laboratory services to clinicians. The civil settlement resolves an investigation conducted by the Medicaid Fraud and Residential Abuse Unit of the Office of the Attorney General into Medicaid claims for urinalysis drug testing made by Physicians Toxicology. The investigation identified five categories of billing improprieties and errors that resulted in the Vermont Medicaid program making overpayments to the company. Physicians Toxicology cooperated with the investigation.
September 18, 2014; New York Attorney General: A.G. Schneiderman Announces National Settlement With Medtronic For Medicaid Violations
NEW YORK - Attorney General Eric T. Schneiderman today announced that 46 states and the District of Columbia have reach a settlement agreement with Minnesota-based company Medtronic to resolve claims under the False Claims Act that Medtronic improperly induced physicians to recommend Medtronic devices to treat cardiac rhythmic disease. New York led a national team composed of members from Oregon, Texas and California to negotiate the settlement. The federal government settled its matter in May of this year.
September 17, 2014; Virginia Attorney General: Medicaid Provider and Wife Convicted of Healthcare Fraud
NORFOLK, Va. - W. Wayne Perry, Jr., 55, and his wife, Angela Perry, 52, formerly of Suffolk, Va., were convicted after a three-week trial late yesterday afternoon by a federal jury of one count of conspiracy to commit health care fraud, four counts of health care fraud, eight counts of false statements relating to health care matters, one count of alteration of records and four counts of aggravated identity theft.
September 12, 2014; Alaska Attorney General: Personal Care Attendant Gets Jail Time for Fraudulently Billing Medicaid $20,569
The Medicaid Fraud Control Unit (MFCU) successfully prosecuted 59 year old Jong H. Choi for falsely billing Medicaid for personal care attendant (PCA) services when he was not authorized to bill Medicaid. MFCU investigators interviewed Choi's wife regarding bills submitted to Medicaid while she was out of the country and/or caring for other recipients. MFCU investigators learned that Choi was forging his wife's name on timesheets submitted to Medicaid for services he was allegedly providing despite being barred by Medicaid from providing services due to a prior criminal conviction. Choi forged his wife's name on a total of $20,569.00 in Medicaid bills which were paid by Medicaid. Choi also submitted $46,875 in Medicaid bills in 2010 under his own name after being notified by Medicaid that he was barred from billing Medicaid until October 28, 2013. The case was jointly investigated by the MFCU, the Department of Health and Social Services and Immigration and Customs Enforcement.
September 17, 2014; Tennessee Department of Finance and Justice: Two Charged With TennCare Fraud in Weakley County
NASHVILLE, Tenn. - Two people are charged in Weakley County with TennCare fraud related to allegedly selling prescription drugs paid for by the state's healthcare insurance program.
September 17, 2014; Tennessee Department of Finance and Justice: Wilson Co. Man Charged With TennCare Drug Fraud
NASHVILLE, Tenn. - A Wilson County man is charged with TennCare fraud for selling prescription drugs paid for by the state's healthcare insurance program.
September 17, 2014; Tennessee Department of Finance and Justice: Mississippi Woman Charged With TennCare Fraud
NASHVILLE, Tenn. - A Mississippi woman is charged with TennCare fraud and theft of property after she received healthcare insurance benefits through the state's healthcare insurance program, even though she was not eligible.
September 16, 2014; Florida Attorney General: Three Arrested for Abusing Vulnerable Adults at Threshold Center for Autism
TALLAHASSEE, Fla.- Attorney General Pam Bondi's Medicaid Fraud Control Unit, the Orange County Sheriff's Office, and the Jacksonville Sheriff's Office arrested three former employees of Threshold Center for Autism. Shenika Abraham, Kenneth Hampton, Jr., and Michael Meeks allegedly abused three residents of the Winter Park residential home. According to the investigation, a former employee of Threshold Center for Autism recorded instances of the alleged abuse on his smart phone. The video and supporting witness statements implicated Abraham, Hampton, and Meeks in three separate incidents of abusing disabled adult residents under their care. Threshold Center for Autism terminated the three employees.
September 15, 2014; Nevada Attorney General: Attorney General Masto Announces Sentencing of Las Vegas Personal Care Assistant
Las Vegas, NV - Nevada Attorney General Catherine Cortez Masto announced that Stephanie Sierad, 43, of Las Vegas, was sentenced today in a Medicaid fraud case involving the submitting of false Medicaid claims.
September 10, 2014; Tennessee Department of Finance and Administration: Hamilton Co. Man Charged With TennCare Fraud
NASHVILLE, Tenn. - A Hamilton County man is charged with TennCare fraud and elder abuse in connection with taking an elder woman's assets so the state would pay for her nursing home care.
September 10, 2014; Oklahoma Attorney General: Oklahoma AG Files Medicaid Fraud Charge against Former Rehab Specialist
OKLAHOMA CITY- Oklahoma Attorney General Scott Pruitt has filed Medicaid fraud charges against a Wichita, Kan., woman for billing the state's Medicaid program for services she did not provide.
September 10, 2014; New York Attorney General: A.G. Schneiderman Announces Arrest Of Nurse For Allegedly Stealing Narcotics From Brain Trauma Nursing Facility Resident
PEARL RIVER - Attorney General Eric T. Schneiderman today announced the arrest of Amy DeAngelis-Martin, a Licensed Practical Nurse formerly employed by Northeast Center for Special Care in the Town of Ulster, New York, for allegedly stealing three oxycodone pills from a resident's prescription for her personal use. DeAngelis-Martin faces felony charges, including Endangering the Welfare of an Incompetent or Physically Disabled Person in the First Degree, and up to four years behind bars.
September 9, 2014; Tennessee Department of Finance and Administration: Hamilton Co. Woman Charged With TennCare Fraud
NASHVILLE, Tenn. - A Hamilton County woman is charged with TennCare fraud for presenting forged prescriptions on four separate occasions to a local pharmacy and using TennCare to pay for the drugs.
September 9, 2014; Tennessee Department of Finance and Administration: Rutherford Co. Woman Charged with TennCare Fraud
NASHVILLE, Tenn. - A Rutherford County woman is charged with TennCare fraud for falsely reporting her income in order to obtain healthcare insurance benefits through the state program.
September 9, 2014; Tennessee Department of Finance and Administration: Weakley Co. Woman Charged A Second Time With TennCare Fraud
NASHVILLE, Tenn. - A Weakley County woman is charged for a second time with doctor shopping, or using TennCare to go to multiple doctors in a short time period to obtain prescriptions for controlled substances.
September 9, 2014; Tennessee Department of Finance and Administration: Kentucky Woman Charged a Second Time with TennCare Fraud
NASHVILLE, Tenn. - A Kentucky woman is charged for the second time with claiming to live in Tennessee in order to obtain TennCare benefits for herself, her husband and her children.
September 8, 2014; Washington Attorney General: Four Medicaid providers convicted of healthcare fraud in Thurston and King County
OLYMPIA - The Attorney General's Office Medicaid Fraud Control Unit (MFCU) recently convicted healthcare providers in four separate Medicaid fraud cases, holding accountable four defendants who did not provide the care they were paid to provide to elderly and other vulnerable adults.
September 8, 2014; Florida Attorney General: Former Levy County Adult Family Care Home Owner Sentenced to More Than Eight Years in Prison
TALLAHASSEE, Fla.- Attorney General Pam Bondi announced that a judge has sentenced Priscilla Smith Johnson, the owner of an adult family care home in Williston, Fla., to more than eight years in prison. Johnson was arrested in October 2013 following an investigation by Attorney General Bondi's Medicaid Fraud Control Unit and the Levy County Sheriff's Office. Allegations against Johnson included neglecting residents, failing to provide medical services for a resident's wounds, restraining a disabled adult with handcuffs both in the family care home and restraining residents at a remote location, willfully abusing a disabled adult and causing wounds on her wrists and permanent disfigurement, and financially exploiting residents at her family care home.
September 5, 2014; Wisconsin Department of Justice: Milwaukee Man Sentenced for Racketeering and Medicaid Fraud as Last Defendant in Scheme
MADISON - Attorney General J.B. Van Hollen announced today that Parnell P. Hyman, of Milwaukee, was sentenced on convictions for racketeering and Medicaid fraud related to the submission of claims for fictitious durable medical equipment - the last of eleven defendants to be convicted and sentenced for the fraudulent scheme.
September 5, 2014; Florida Attorney General: Four Central Residents Arrested for Medicaid Fraud
TALLAHASSEE, Fla.-Attorney General Pam Bondi's Medicaid Fraud Control Unit, the Apopka Police Department, and the Winter Springs Police Department today arrested Anayanzi Carrington-Simpson, Danyel Hancock, Shanqual Marshall-Gunn, and Kristina Mineo for Medicaid fraud. The defendants were employed by Second Chances TCM, Inc. and allegedly billed the Medicaid program for more than $47,000 worth of targeted case management services that were fraudulent or not authorized. Targeted case management service providers (TCMs) are intended to assist Medicaid recipients who have a persistent and serious mental health disorder by linking them to community resources. According to the investigation, Marshall-Gunn, the owner of Second Chances TCM, Inc., paid kick backs to employees and clients for referrals. Carrington-Simpson, Hancock, Marshall-Gunn, and Mineo allegedly submitted claims for unauthorized services, duplicative services, and services which were not provided.
September 4, 2014; Florida Attorney General: Attorney General Bondi's Office and Others Arrest Individuals for $1 Million of Medicaid Fraud
TALLAHASSEE, Fla.- Attorney General Pam Bondi's Medicaid Fraud Control Unit, the Miami-Dade Police Department, the Kansas Medicaid Fraud Control Unit, the Shawnee County Sheriff's Office and the New Jersey Medicaid Fraud Control Unit today arrested Grisel Pena, 63, Barbara Oldham-Kennedy, 40, and Robert Patrick Garcia, 38, on felony warrants for allegedly defrauding Medicaid out of more than $1 million. The defendants allegedly submitted falsified claims for services not rendered to several Medicaid recipients and received payment based on falsified claims. Grisel Pena, Barbara Oldham-Kennedy and Robert Patrick Garcia are each facing charges of Medicaid fraud, grand theft and organized fraud, all first-degree felonies. If convicted, they each face up to 90 years in prison. This case will be prosecuted by the Attorney General's Office of Statewide Prosecution.
September 3, 2014; Tennessee Department of Finance and Administration: Hamilton Co. Woman Charged With TennCare Dodctor Shopping
NASHVILLE, Tenn. - A Hamilton County woman is charged with TennCare fraud involving doctor shopping, a crime that involves going to multiple doctors to obtain controlled substances, using TennCare as payment.
September 3, 2014; Tennessee Department of Finance and Administration: Greene Co. Men Charged With TennCare Fraud
NASHVILLE, Tenn. - A Greene County man is accused of using another person's identity in order to fraudulently obtain healthcare insurance benefits through TennCare. The other person involved is also charged for helping him commit the crime.
September 3, 2014; New York Attorney General: A.G. Schneiderman Announces Indictment Of Long Island Nurse On Charges Of Attempting To Cover Up Morphine Overdose Of Patient
HAUPPAUGE - Attorney General Eric T. Schneiderman today announced the unsealing of a felony indictment charging Vicki Price, a licensed practical nurse, in connection with a morphine overdose of a wheelchair-bound resident at Bayview Nursing and Rehabilitation Center, at 1 Long Beach Road in Island Park. If convicted, Price, 46, faces up to 4 years in prison.
September 3, 2014; Kansas Attorney General: Leavenworth doctor to repay $12,000 for Medicaid fraud
LEAVENWORTH - A Leavenworth doctor must repay more than $12,000 after being found guilty of Medicaid fraud, Kansas Attorney General Derek Schmidt said.
September 2, 2014; New Jersey Attorney General: Cream Ridge Doctor Indicted for Allegedly Seeking Payment for 40 Medical Diagnostic Procedures He Never Conducted
TRENTON - Acting Attorney General John J. Hoffman and the Office of the Insurance Fraud Prosecutor today announced today a 43-count indictment from the state grand jury that charges a Cream Ridge doctor for allegedly submitting claims to insurance carriers for nerve conduction studies he never actually performed.
September 2, 2014; Tennessee Department of Finance & Administration: Coffee Co. Woman Charged With TennCare Drug Fraud
NASHVILLE, Tenn. - A Coffee County woman is charged with TennCare fraud for selling prescription drugs paid for by TennCare.

August 2014

August 29, 2014; Kentucky Attorney General: Attorney General Conway Announces Sentencing of Former CDO Employee
Attorney General Jack Conway and his Medicaid Fraud and Abuse Control Unit today announced the sentencing of a former Consumer Directed Options (CDO) employee on a charge involving Medicaid fraud.
Friday, August 29, 2014; Kentucky Office of the Attorney General: AG Conway Announces Nearly $16.5 Million Settlement with Omnicare
Attorney General Jack Conway and his Medicaid Fraud and Abuse Control Unit today announced that Kentucky has joined with other states and the federal government in a $16.48 million settlement with Omnicare Inc., the nation's largest provider of pharmaceuticals and pharmacy services to nursing homes. The settlement resolves allegations that Omnicare offered improper financial incentives to skilled nursing facilities in return for their continued selection of Omnicare to supply drugs to Medicaid recipients. Kentucky's total share of the settlement is $348,975.84. The federal government will receive $240,130.55 for its share of Kentucky-related damages.
August 28, 2014; New York Attorney General: A.G. Schneiderman Announces Arrests Of Unlicensed Dentists On Charges They Treated Patients At Brooklyn Clinics
NEW YORK - Attorney General Eric T. Schneiderman today announced the arrests of four individuals for allegedly practicing dentistry without a license at two Brooklyn dental clinics, which are separately owned by a father and his son who are licensed dentists. The men, arrested on felony charges, are Konstantin Shtrambrand, Ilya Zolotar, Sergey Tolokolnikov, and Hakob Gahnapetyan. If convicted, they face up to four years in prison.
August 26, 2014; Tennessee Department of Finance & Administration: Mississippi Woman Must Repay Tennessee
NASHVILLE, Tenn. - A Mississippi woman charged with lying to the state in order to obtain TennCare healthcare insurance benefits is now order to repay the state program for payments made on her behalf. The Office of Inspector General today announced a judgment against 51-year old Joann Shorter, also known as Joann Moore, of Walls, Mississippi. She was arrested in March of this year when she was charged in connection with falsifying statements in order to appear eligible for TennCare. A Shelby County Criminal Court has ordered Shorter to pay restitution in the amount of $12,452.00, along with five years of supervised judicial diversion.
August 26, 2014; Tennessee Department of Finance & Administration: Sevier Co. Man Faces 3rd TennCare Fraud Charge
NASHVILLE, Tenn. - A Sevier County man is charged for the third time with doctor shopping for controlled substances, using TennCare healthcare insurance benefits as payment. The Office of Inspector General today announced the arrest of Clark Michael Shelton, 37, of Kodak. A Sevier County Grand Jury charged him with four counts of doctor shopping for controlled substances. In addition, Shelton was charged with three counts of obtaining a controlled substance by fraud.
August 22, 2014; New York Attorney General: A.G. Schneiderman Announces Guilty Plea By Medication Technician Who Stole Approximately 650 Prescription Narcotics From Elderly Nursing Facility Residents For Personal Use
ROCHESTER - Attorney General Eric T. Schneiderman today announced the guilty plea of Deborah Cleveland, 42, of Rochester, for stealing approximately 650 prescription narcotics from a total of eight elderly patients at the Heather Heights Assisted Living and Memory Care Facility in the Town of Pittsford. Cleveland was previously employed as a medication technician at the facility, where she stole prescription narcotics for personal consumption and attempted to conceal the theft by substituting pills with a similar appearance. Cleveland pled guilty to the misdemeanor crime of Attempted Scheme to Defraud in the 1st Degree before The Honorable John Bernacki in Pittsford Town Court.
August 22, 2014; New York Office of the Medicaid Inspector General: Medicaid Ban Continued For Health Aide Convicted Of $50K Fraudulent Billing
Sitora Adashzoda recently applied for removal from the Office of the Medicaid Inspector General (OMIG) list of excluded providers. Adashzoda had previously run into trouble because she was not authorized to work in the United States but had done so nevertheless, providing home health services for which she was not certified. She also billed more than $50,000 for those services by using another woman's name.
August 22, 2014; Tennessee Department of Finance & Administration: Dyer County Woman Charged With Doctor Shopping
NASHVILLE, Tenn. - A Dyer County woman is charged with TennCare fraud involving doctor shopping, or using the state's Medicaid benefits to go to multiple providers in a short period of time in order to obtain controlled substances. The Office of Inspector General, with assistance from the Dyer County Sheriff's Office and the Dyersburg Police Department, today announced the arrest of 37-year old Adrienne Karathanasis, of Newbern.
August 22, 2014; Tennessee Department of Finance & Administration: Knox, Bedford Co. Men Charged With Doctor Shopping
NASHVILLE, Tenn. - Knox and Bedford County residents are charged with doctor shopping for drugs, using TennCare healthcare insurance benefits as payment. For one of the men, it's the second time he's been charged with the crime, which involves going to multiple doctors in a short period of time to obtain controlled substances. The Office of Inspector General today announced the arrest of Jonathan Presnell, 33, of Knoxville and Brian Keith Tucker, 39, of Shelbyville.
August 22, 2014; Tennessee Department of Finance & Administration: Blount Co. Woman Charged With TennCare Fraud
NASHVILLE, Tenn. - A Blount County woman is charged with TennCare fraud for receiving benefits through the state's Medicaid program that she was not eligible to receive. The Office of Inspector General, with assistance from the Blount County Sheriff's Office, today announced the arrest of Cherie Boston, 49, of Maryville. She is charged with TennCare fraud and theft of services.
August 21, 2014; Massachusetts Attorney General: Owner of Medical Transportation Company Sentenced to Jail for Billing Taxpayers for Rides Under Dead People's Names
WORCESTER - The owner of a medical transportation company in Webster has been sentenced to a year and a half in jail and ordered to pay full restitution for defrauding the state's Medicaid program (MassHealth) of more than $470,000 by billing for services under the names of deceased individuals, and for other medical trips that were never provided, Attorney General Martha Coakley announced today.
August 20, 2014; Mississippi Attorney General: Hinds County Resident Going to Prison for Exploitation of Vulnerable Person
A Hinds County man is going to prison for 20 years for exploitation of a vulnerable person, announced Attorney General Jim Hood today. Gregory Wayne Colburn, 52, of Jackson, was sentenced Tuesday by Rankin County Circuit Court Judge William Chapman on two counts of exploitation of a vulnerable person.
August 20, 2014; New York Attorney General: A.G. Schneiderman Announces $2.2 Million Settlement With New Rochelle Nursing Home For Fraudulent Billings
BROOKLYN - Attorney General Eric T. Schneiderman and U.S. Attorney Loretta Lynch today announced that they have entered into settlement agreements with a New Rochelle nursing home resolving allegations that the facility and its owner submitted tens of thousands of inflated claims to the New York State Medicaid Program. The claims sought reimbursement for services provided, but at artificially high rates. Under the agreements, Ralex Services, Inc., doing business as Glen Island Center for Nursing and Rehabilitation, and its owner, Leah Friedman, will return $2.2 million to Medicaid, a program jointly funded by the state and federal governments. New York will receive $1,320,000 of the total restitution funds.
August 20, 2014; New York Attorney General: A.G. Schneiderman Announces Arrest Of Home Health Care Worker Facing Felony Charges Of Medicaid Theft
ROCHESTER - Attorney General Eric T. Schneiderman today announced that his office has filed felony charges against Alicia Santiago, a home health care aide from Rochester, who allegedly submitted phony time sheets to Innovative Care, LLC, which, relying on Santiago's false time sheets, billed Medicaid for work Santiago had not performed. The defendant was arrested last night and arraigned in the Town of Gates Justice Court before the Honorable Peter P. Pupatelli.
August 20, 2014; New York Office of Medicaid Inspector General: Nurse Who Billed Medicaid While on Caribbean Cruise Sentenced
The Office of the Medicaid Inspector General received a complaint in September 2011 alleging that Licensed Practical Nurse Tammy Beth Wojtach was billing Medicaid for services not rendered. Her fraudulent billing was discovered after she left a position in which she cared for a 10-year-old recipient with cerebral palsy. When the new nurse submitted bills for the same recipient, the claims were denied by Medicaid because Wojtach had already used all of the approved hours from the patient's Medicaid prior authorization.
August 20, 2014; Tennessee Department of Finance & Administration: Alabama Woman Ordered To Repay State After TennCare Fraud Conviction
NASHVILLE, Tenn. - An Alabama woman charged with TennCare fraud for claiming to live in Tennessee must now repay the state over $54,000 for healthcare insurance benefits paid on her behalf by TennCare. The Office of Inspector General today announced that Melissa Burns, 38, of Florence, Alabama, must repay the state for payments made due to healthcare services she and her family received while they were on TennCare. A Wayne County Criminal Court ordered Burns to repay TennCare a total of $54,225.30. In addition, she was ordered to serve six months in jail, and afterward report to a probation officer until the year 2030.
August 18, 2014; Kentucky Attorney General: AG Conway Announces Sentencing and Guilty Plea in Two Related Cases Involving Former Caregivers
Attorney General Jack Conway and his Medicaid Fraud and Abuse Control Unit have announced the sentencing of a former owner and operator of an in-home caregiving service on a charge of defrauding the Medicaid program. On Aug. 15, 52-year-old Sheryl Bruner was sentenced in Fayette Circuit Court to 18 months in prison and was ordered to pay $550,000 in restitution to the Kentucky Department for Medicaid Services.
August 15, 2014; Delaware Attorney General: Biden's Office Arrests Nursing Assistant On Patient Abuse Charges
Wilmington - An investigation by the Attorney General's Medicaid Fraud Control Unit has led to the arrest of 57-year-old Angela Coverdale, of Wilmington, a certified nursing assistant formerly employed at the Emily Bissell Hospital, a long-term care nursing home located in New Castle County.
August 15, 2014; Tennessee Department of Finance & Administration: Williamson, Shelby Co. Women Charged With Doctor Shopping
NASHVILLE, Tenn. - Two Tennessee women are charged with doctor shopping for controlled substances, using TennCare as payment. The Office of Inspector General today announced the arrest of Jessica L. Gore, 35, of Fairview, an arrest assisted by Williamson County Sheriff's officers, and Tracie Hester, 43, of Germantown in Shelby County.
August 13, 2014; Massachusetts Attorney General: Owner of Medical Transportation Company Pleads Guilty to Billing Taxpayers for Rides Under Dead People's Names
WORCESTER - The owner of a medical transportation company in Webster has pleaded guilty to defrauding the state's Medicaid program (MassHealth) of more than $470,000 by billing for services under the names of deceased individuals, and for other medical trips that were never provided, Attorney General Martha Coakley announced today.
August 13, 2014; Florida Attorney General: Seminole County Woman Arrested for Medicaid Fraud
TALLAHASSEE, Fla.-An investigation by Attorney General Pam Bondi's Medicaid Fraud Control Unit today resulted in the arrest of a Seminole County woman, Teryl Atkins, for medicaid fraud. Atkins was employed by A&S Quality Care, where she allegedly billed the Medicaid program for more than $8,000 in services that were deemed fraudulent, duplicative, or not authorized for reimbursement. Atkin's arrest follows the arrests of her A&S coworkers, Shirley Simmons, Keisha Carter and Kandida Michel, in July. According to the investigation, A&S paid illegal kickbacks to employees for the referral of new Medicaid recipients and billed the Medicaid program for more than $45,000 in duplicative and unauthorized services.
August 13, 2014; Tennessee Department of Finance & Administration: Sevier Co. Man, On The Run For 17 Months, Arrested On TennCare Drug Fraud Charges
NASHVILLE, Tenn. - After being on the run for the past 17 months, a Sevier County man faces a second round of "doctor shopping" charges, associated with going to multiple doctors to obtain controlled substances and using TennCare as payment. The Office of Inspector General today announced the arrest of Clark Michael Shelton, 37, of Kodak. A Greene County Grand Jury indicted Shelton on March 25, 2013, charging him with six counts of "doctor shopping" for the painkiller Lortab, in addition to six counts of obtaining a controlled substances by fraud.
August 12, 2014; New York Attorney General: A.G. Schneiderman Announces Four Arrests and $6.5 Million Settlement for Medicaid Fraud at Brooklyn Adult Care Facility
NEW YORK -- Attorney General Eric T. Schneiderman today announced that four employees of the Northern Manor Adult Day Health Care Program (Northern Manor ADHC), a health care facility in Brooklyn providing services to the elderly, have been arrested after a long-term investigation. As a condition of the settlement, Attorney General Schneiderman required that the facility be shut down. Furthermore, Northern Manor Multicare Center, Inc., the nursing home that operates the Brooklyn program, has agreed to pay a $6.5 million civil settlement in connection with this case.
August 12, 2014; New York Attorney General: A.G. Schneiderman Announces Arrest Of A Rochester Healthcare Worker For Striking A 90-Year-Old Nursing Home Patient Suffering From Dementia
ROCHESTER - Attorney General Eric T. Schneiderman today announced the arrest of Adrian King, a certified nursing assistant (CNA), for hitting a 90-year-old female patient suffering from dementia. King is charged with one count of Endangering the Welfare of a Vulnerable Elderly Person or an Incompetent or Physically Disabled Person in the Second Degree, Wilful Violation of Health Laws, and Harassment in the Second Degree.
August 12, 2014; Tennessee Department of Finance & Administration: Grainger Co. Woman Charged With TennCare Fraud, Identity Theft
NASHVILLE, Tenn. - A Grainger County woman is charged in Hamblen County with aiding and abetting another person in an illegal attempt to acquire TennCare healthcare insurance benefits they were not eligible to receive. The Office of Inspector General today announced the arrest of Maria Morales Santos, 39, of Washburn.
August 11, 2014; Texas Attorney General: Attorney General Abbott Recovers $19.5 Million for State of Texas, U.S.
AUSTIN - Texas Attorney General Greg Abbott secured a $19.5 million agreement with Taro Pharmaceuticals USA, Inc. The agreement resolves the State's civil Medicaid fraud investigation against Taro for fraudulently reporting inflated drug prices to the Medicaid program.
August 8, 2014; Florida Attorney General: Hillsborough County Woman Arrested for Exploitation of an Elderly Person
TALLAHASSEE, Fla. -Attorney General Pam Bondi's Medicaid Fraud Control Unit (MFCU), the Florida Department of Corrections Probation Division and the Tampa Police Department today arrested Rosalinda Rivera for exploitation of an elderly person. Rivera allegedly abused her authorization as power of attorney for her elderly and disabled mother to exploit more than $65,000.
August 7, 2014; New York Attorney General: A.G. Schneiderman Announces The Arrest Of Woman For Allegedly Impersonating A Licensed Practical Nurse At A Far Rockaways Nursing Home
NEW YORK - Attorney General Eric T. Schneiderman today announced the arrest of Noucheline Jean, 42, of Brooklyn, for allegedly masquerading as a licensed practical nurse (LPN) at Park Nursing Home, located in Far Rockaway, Queens. From October 15, 2012, to April 29, 2014, the defendant was employed by Park Nursing Home as an LPN, having convinced her employers that she was properly licensed to do so. Because the defendant never obtained a license in New York State, she was unqualified to perform the duties of a nurse. She faces Grand Larceny charges -- and up to 15 years in prison -- for taking $90,000 in salary she was not qualified to earn.
August 6, 2014; New York Attorney General: A.G. Schneiderman Announces Settlement with Pfizer to End Deceptive Advertising Practices and Off-label Promotion of Immunosuppressive Drug Rapamune
NEW YORK -- Attorney General Eric T. Schneiderman today announced that he, along with 40 other state Attorneys General and the District of Columbia, reached a $35 million settlement with Pfizer arising from alleged improper marketing and promotion of the immunosuppressive drug Rapamune. New York's share of the settlement is over $1.7 million. Pfizer, as parent of Wyeth Pharmaceuticals Inc., agrees to be bound by the judgment and to resolve allegations that Wyeth unlawfully promoted Rapamune. Attorney General Schneiderman's office served on the Executive Committee of this multi-state investigation.
August 6, 2014; Tennessee Department of Finance & Administration: Weakley Co. Woman Charged With TennCare Fraud
NASHVILLE, Tenn. - A Weakley County woman is charged in Carroll County with TennCare fraud involving doctor shopping, which is the crime of going to multiple doctors in a short period of time in order to obtain controlled substances. The Office of Inspector General, with assistance from Metro Nashville Police and Carroll County Sheriff's officers, today announced the arrest of Jodi D. Wilson, 26, of Martin.
August 5, 2014; Alabama Attorney General: AG Announces Conviction Of Former Nursing Home Bookkeeper For Theft Of Residents' Funds
(MONTGOMERY) -Attorney General Luther Strange announced the conviction today of a former employee of a DeKalb County nursing home for the theft of more than $5,000 from the facility's resident trust fund. Kimberly Yvette Nance, 41, of Rainsville, pleaded guilty this afternoon before DeKalb County Circuit Judge Randall Cole to one count of first-degree theft of property Nance previously had been indicted by the November 2013 term of the DeKalb County Grand Jury.
August 5, 2014; Tennessee Department of Finance & Administration: Jefferson Co. Woman Facing 3rd TennCare Fraud Charge
NASHVILLE, Tenn. - A Jefferson County woman is charged in both Knox and Hamblen Counties for TennCare fraud involving doctor shopping, or using TennCare to go to multiple doctors in a short time period to obtain prescriptions for controlled substances. The Office of Inspector General, assisted by the Hamblen and Knox County Sheriff's Offices, today announced the arrest of Shirley Jean Whitehead, also known as Shirley Jean Barnes, 47, of Jefferson City. She is charged in Knox County with doctor shopping and six counts of obtaining a controlled substance by fraud. Barnes was transferred to Knox County from Hamblen County, where she is charged with two counts of doctor shopping.
August 5, 2014; Tennessee Department of Finance & Administration: Bradley Co. Woman Charged With TennCare Drug Fraud
NASHVILLE, Tenn. - A Bradley County woman is charged with TennCare fraud in connection with selling prescription drugs which were paid for by the state's Medicaid healthcare insurance program. The Office of Inspector General today announced the arrest of Barbara Sue Greer, 50, of Cleveland, after a joint investigation with the Bradley County Sheriff's Department.
August 4, 2014; Tennessee Department of Finance & Administration: Giles County Man Charged 2nd Time With TennCare Doctor Shopping
NASHVILLE, Tenn. - A Giles County man is charged with TennCare doctor shopping for a second time this summer. Doctor shopping involves visiting multiple doctors in a short period of time - less than a month - to obtain controlled substances, and using TennCare healthcare insurance to pay for the visits, the prescriptions, or both. The Office of Inspector General, with the assistance of the Maury County Sheriff's Office, today announced the arrest of 49-year old Woodrow Beddingfield, of Pulaski.
August 1, 2014; Kansas Attorney General: Emporia woman found guilty of mistreatment of dependent adult
EMPORIA - An Emporia woman was found guilty yesterday of mistreating a dependent adult and conspiring to mistreat a dependent adult, Kansas Attorney General Derek Schmidt said.
August 1, 2014; Kansas Attorney General: AG Schmidt: 2014 Medicaid Fraud Recoveries Top $28 Million
TOPEKA - The Kansas attorney general's office recovered more than $28 million in taxpayer funds through its Medicaid fraud enforcement during the recently ended state fiscal year, Kansas Attorney General Derek Schmidt said today.

July 2014

July 31, 2014; Tennessee Department of Finance & Administration: Kentucky Woman Charged With TennCare Fraud; Record July for TennCare Fraud Arrests
NASHVILLE, Tenn. - A Kentucky woman has been charged with misrepresenting her residency in order to obtain TennCare benefits for herself and her family. The arrest means that July marked the most people charged with TennCare fraud in any July since the program started in 2005. This month, 24 were charged with TennCare fraud by the Office of Inspector General. The latest arrest is Natali J. Monrroy, 28, of Adairville, Kentucky.
July 30, 2014; Washington State Office of the Attorney General: Attorney General Charges Wheelchairs Plus with Medicaid Fraud
OLYMPIA - The Washington State Attorney General's Office has filed criminal charges against Michael Mann, owner of Wheelchairs Plus Inc., in Thurston County Superior Court. The AGO alleges Mann committed the crimes of First Degree Theft and Medicaid False Statement when he fraudulently provided 119 Medicaid recipients with used or refurbished wheelchairs while billing Medicaid as if they were new. Mann billed the State Medicaid system a total of $606,980 for the wheelchairs.
July 30, 2014; New York State Office of the Attorney General: A.G. Schneiderman Announces Settlement With Brooklyn Medical Center That Ran Satellite Facility Without An Operating Certificate
NEW YORK - Attorney General Eric T. Schneiderman today announced that New York State and the federal government have entered into a $600,000 settlement agreement with Brooklyn Plaza Medical Center to resolve allegations that the diagnostic and treatment center ran a satellite facility, the Whitman Ingersoll Farragut Health Center, without an operating certificate. The settlement also resolves allegations that Brooklyn Plaza Medical Center disguised the satellite facility's Medicaid billings to make them appear as if the services were rendered at the Brooklyn Plaza Medical Center, not the satellite center. Those fraudulent billings caused the Medicaid program to offer inflated reimbursements for services rendered. The settlement money will go to reimburse the State of New York and the federal government for their contributions to the New York State Medicaid Program.
July 30, 2014; Georgia Department of Law: Lithonia Woman Accused of Fraudulently Obtaining More than $355K from Georgia Medicaid
On Tuesday, July 29, 2014, a DeKalb County Grand Jury charged Shirley Dorsey, of Lithonia, Ga., with one count of Medicaid Fraud (O.C.G.A. § 49-4-146.1(b)), one count of violating the Georgia Racketeer Influenced and Corrupt Organizations Act (RICO) (O.C.G.A. § 16-14-4(a)), one count of Theft by Taking (O.C.G.A. § 16-8-2), two counts of Forgery (O.C.G.A. § 16-9-1(a) ), four counts of Identity Theft (O.C.G.A. § 16-9-121) and two counts of False Writings (O.C.G.A. § 16-10-20). Ms. Dorsey is accused of obtaining over $355,000 through the fraudulent billing of Georgia Medicaid.
July 29, 2014; Tennessee Department of Finance & Administration: Robertson Co. Woman Charged With TennCare Doctor Shopping
NASHVILLE, Tenn. - A Robertson County woman is charged in nearby Sumner County with TennCare fraud involving doctor shopping, or using TennCare to go to multiple doctors in a short time period to obtain controlled substances. The Office of Inspector General, with assistance from Goodlettsville Police and the Sumner County Sheriff's Office, today announced the arrest of Brandy N. Brooks, 28, of Greenbriar
July 29, 2014; Tennessee Department of Finance & Administration: Shelby Co. Man Charged With TennCare Doctor Shopping
NASHVILLE, Tenn. - A Shelby County man is charged in with TennCare fraud involving doctor shopping, or using TennCare to go to multiple doctors to obtain controlled substances. The Office of Inspector General, with the assistance from the Shelby County Sheriff's Office, today announced the arrest of Kevin Q. Holmes, of Memphis.
July 28, 2014; Tennessee Department of Finance & Administration: Warren County Man Charged With TennCare Drug Fraud
NASHVILLE, Tenn. - A Warren County man is charged with TennCare fraud in connection with selling prescription drugs paid for by the state's Medicaid program. The Office of Inspector General today announced the arrest of David Rios Flores, 57, of McMinnville, after a joint investigation with the Warren County Sheriff's Office.
July 25, 2014; Tennessee Department of Finance & Administration: Georgia Woman Charged With TennCare Fraud
NASHVILLE, Tenn. - A Georgia woman is charged with TennCare fraud in an indictment accusing her of falsely reporting her income to the state in order to obtain TennCare benefits. The charges are based on activities that occurred when she lived in Tennessee. The Office of Inspector General and the Polk County, Tennessee, Sheriff's Office today announced the arrest of Virginia Carter, 46, of Mineral Bluff, Georgia.
July 25, 2014; State of Alaska Department of Law: Anchorage Psychiatrist Indicted for Medicaid Fraud, Evidence Tampering and Misconduct Involving Controlled Substance
The State of Alaska, Department of Law, Medicaid Fraud Control Unit (MFCU), announced today the indictment of an Anchorage area physician. Dr. Shubhranjan Ghosh, 39, of Anchorage and founder of Ghosh Psychiatric Services, was indicted yesterday by a grand jury on 18 felony counts for fraudulently billing Medicaid, committing a scheme to defraud Medicaid, tampering with physical evidence in an ongoing investigation and 15 counts of misconduct involving a controlled substance. Dr. Ghosh will be arraigned on Monday, July 28, 2014 at 1:45 p.m.
July 25, 2014; Office of the Attorney General of Mississippi: Horn Lake Nurse Arrested for Possession of Controlled Substance
A Horn Lake nurse has been arrested for alleged possession of a controlled substance, announced Attorney General Jim Hood today.
July 25, 2014; Maryland Attorney General: AG Gansler: Astellas Pharma US Inc. Pays $7.3 Million to Resolve False Claims Act Allegations Related to Marketing of Antifungal Agent?
Baltimore, MD (July 25, 2014) - Attorney General Douglas F. Gansler announced today that Maryland, joined by multiple states and the federal government, has settled allegations that Astellas Pharma US, Inc. (Astellas) caused false claims to be submitted to federal and state health care programs in connection with its marketing and promotion of the drug Mycamine for pediatric use. Mycamine is a sterile, lyophilized (freeze-dried) antifungal agent that was approved only for use by adults. As part of the settlement, Astellas will pay $13,583.96 to the Maryland Medicaid program.
July 25, 2014; New York State Office of the Attorney General: A.G. Schneiderman Announces Arrest Of Medication Technician For Allegedly Stealing Prescription Narcotics From Elderly Nursing Home Residents For Personal Use
ROCHESTER - Attorney General Eric T. Schneiderman today announced the arrest of Deborah Cleveland, 42, a medication technician formerly employed by Heather Heights Assisted Living and Memory Care Facility in the Town of Pittsford. Cleveland is facing 17 charges for allegedly stealing a total of 650 narcotic pills for personal use from eight patients ranging in age from 66 to 98 years old. Cleveland allegedly substituted non-narcotic medications, including allergy, diuretic, bi-polar, and blood pressure medications that were not prescribed for the patients in question.
July 24, 2014; Tennessee Department of Finance & Administration: Putnam Co. Woman Charged With TennCare Doctor Shopping
NASHVILLE, Tenn. - A Putnam County woman is charged with TennCare fraud involving doctor shopping, which is the crime of using TennCare healthcare insurance benefits to go to multiple doctors in a short time period to obtain controlled substances. The Office of Inspector General, with assistance from Cookeville Police and Putnam County Sheriff's officers, today announced the arrest of Cindee S. Newton, 45, of Cookeville. She is charged with doctor shopping for the anti-anxiety medication Alprazolam, a controlled substance.
July 24, 2014; Idaho Attorney General: Idaho Falls Woman Sentenced for Medicaid Fraud
(Boise) - Robin Villarreal-Ratcliff, of Idaho Falls, has been sentenced for using a computer to submit fraudulent claims for Medicaid services, Attorney General Wasden announced today. Villarreal-Ratcliff operated a family alternative care home that provided personal care services (PCS) in Idaho Falls. During the time period of February 2011 to March 2012, Villarreal-Ratcliff billed Medicaid for providing personal care services to two Medicaid recipients who were children when those services were not actually provided by her, because she was vacationing in Costa Rica; Seattle, Washington; Pensacola, Florida; and Lihue, Hawaii.
July 24, 2014; Tennessee Department of Finance & Administration: Hamilton Co. Woman Charged With TennCare Fraud, Id Theft
NASHVILLE, Tenn. - A Hamilton County woman is charged with TennCare fraud and identity theft for obtaining medical treatment and using a TennCare member's benefits to pay for them. The Office of Inspector General today announced the arrest of Deborah Faye Ellis, also known as Deborah Hanes, Deborah F. Lee, and Deborah Faye Lee, 58, of Chattanooga.
July 23, 2014; Tennessee Department of Finance & Administration: Cocke Co. Woman Charged Third Time This Month With TennCare Doctor Shopping
NASHVILLE, Tenn. - A Cocke County woman is charged in Sevier County with TennCare fraud involving doctor shopping, or using TennCare to go to multiple doctors in a short time period to obtain controlled substances. The Office of Inspector General today announced the arrest of Terra S. Keller, also known as Terra Thomas, 33, of Newport. A Sevier County indictment accuses Keller of five counts of doctor shopping for controlled substances, using TennCare as payment. She is also charged with five counts of obtaining a controlled substance by fraud.
July 23, 2014; Tennessee Department of Finance & Administration: Shelby Co. Woman Charged With TennCare Doctor Shopping
NASHVILLE, Tenn. - A Shelby County woman is charged with TennCare fraud involving doctor shopping, or using TennCare to visit multiple doctors in a short time period in order to obtain controlled substance prescriptions. The Office of Inspector General, with assistance from Memphis Police, today announced the arrest of Brenda Walton, 56, of Cordova. She is charged with three counts of doctor shopping for drugs, using TennCare as payment.
July 23, 2014; Tennessee Department of Finance & Administration: Four People Charged With TennCare Drug Fraud
NASHVILLE, Tenn. - Four people are charged with TennCare drug fraud in Weakley County, after an undercover operation. The Office of Inspector General today announced the arrests, which were the result of a joint effort with the Weakley County Sheriff's Office. All four arrests involve the sale of prescription drugs paid for by TennCare:
July 21, 2014; Mississippi Attorney General: Indianola Woman Arrested in Exploitation Case Involving Vulnerable Person
An Indianola woman has been arrested and charged with one count of felony exploitation of a vulnerable person, announced Attorney General Jim Hood today. Francine Byrd Brown, 51, was arrested today by investigators with the Medicaid Fraud Control Unit of the Mississippi Attorney General's Office. Brown, working as a Resident Assistant at a personal care home in Indianola, is accused of taking over $300 from a resident's wallet over a period of time from on or about June 20, 2014, through on or about July 21, 2014.
July 22, 2014; Kansas Attorney General: Winfield woman sentenced for Medicaid fraud in Osage County
LYNDON - A Winfield woman was ordered yesterday to repay more than $5,000 to the Kansas Medicaid program after pleading no contest to Medicaid fraud charges, Kansas Attorney General Derek Schmidt said.
July 21, 2014; Oklahoma Attorney General: Lawton Counselor Pleads No Contest to Medicaid Fraud Charges
July 21, 2014; Tennessee Department of Finance & Administration: Cocke County Woman Charged 2nd Time With TennCare Fraud
July 17, 2014; Nevada Attorney General: Attorney General Masto Announces Conviction of Medicaid Provider
July 15, 2014; Michigan Attorney General: Schuette Announces Felony Charges in Southeast Michigan Unlicensed Doctor Scam
July 18, 2014; Georgia Attorney General: Atlanta OB/GYN Pleads Guilty to Medicaid Fraud and Aiding the Unlicensed Practice of Medicine
On Thursday, July 17, 2014, Nathaniel Johnson, of Atlanta, Ga., pled guilty to one felony count of Medicaid Fraud, one felony count of Conspiracy to Defraud the State and one felony count of allowing the Unlicensed Practice of Medicine. Johnson fraudulently billed Georgia Medicaid for services performed by an unlicensed and unsupervised medical school graduate.
July 18, 2014; Tennessee Department of Finance & Administration: Madison County Man Charged With TennCare Fraud
NASHVILLE, Tenn. - A Madison County man is charged with TennCare fraud in connection with obtaining benefits through the healthcare insurance program, even though he wasn't eligible. The Office of Inspector General, with the assistance of the Madison County Sheriff's Office, today announced the arrest of Joe Ray Phelps, 54, of Jackson.
July 17, 2014; Florida Attorney General: Attorney General Bondi's Office Arrests Three Orange County Women for Medicaid Fraud
TALLAHASSEE, Fla. -Attorney General Pam Bondi's Medicaid Fraud Control Unit, the Winter Garden Police Department, the Orlando Police Department and the Polk County Sheriff's Office arrested three Orange County residents, Shirley Simmons, 46, Keisha Carter, 36, and Kandida Michel-Ross, 36, following allegations of Medicaid fraud for billing more than $45,000 worth of fraudulent, duplicative and unauthorized mental health targeted case management services. Mental Health Targeted Case Management services are designed to link Medicaid recipients having persistent and serious mental health disorders to community based services.
July 17, 2014; Florida Attorney General: Two Escambia County Assisted Living Facility Employees Arrested for Abuse and Neglect
Tallahassee, Fla.- Attorney General Pam Bondi 's Medicaid Fraud Control Unit today arrested Escambia County Assisted Living Facility Administrator, Belie Brock Williams and Assistant Administrator Adrienne Taylor. Williams allegedly refused psychological nursing caregivers entrance into the Kipling Manor facility to assist mental health residents resulting in residents without care for two to three weeks. Taylor allegedly failed caregiver responsibilities to protect the residents from the abuse and did not ensure residents received prescribed nursing services. Investigators received information regarding the alleged abuse and neglect from the Northwest Florida Long Term Care Ombudsman Program Office.
July 17, 2014; Tennessee Department of Finance & Administration: Tipton Co. Woman Charged With TennCare Drug Fraud
NASHVILLE, Tenn. - A Tipton County woman is charged with TennCare fraud for selling prescription drugs paid for by the state's healthcare insurance program. The Office of Inspector General today announced the arrest of Sonya Marie Hill, 32, of Covington, after a joint investigation with the Covington Police Department. Hill was served on the charge while she was being arraigned in a Tipton County Criminal Court on charges related to this case. Charges accuse her of obtaining the anti-anxiety medication Alprazolam with TennCare benefits, and selling a portion of the drug.
July 17, 2014; Tennessee Department of Finance & Administration: Campbell Co. Woman Charged With TennCare, Snap Fraud
NASHVILLE, Tenn. - A Campbell County woman is charged in Scott County with falsely reporting her assets in order to qualify for TennCare healthcare insurance benefits, and Supplemental Nutrition Assistance Program (SNAP, previously known as food stamps.) The Office of Inspector General, with the assistance of the Scott County Sheriff's Office, today announced the arrest of Teresa Jean Willoughby, 43, of Pioneer. She is charged with TennCare fraud, SNAP fraud, two counts of theft of services and perjury.
July 15, 2014; Maryland Attorney General: Catonsville Woman Pleads Guilty to Neglect of Disabled Adult
Baltimore, MD - Attorney General Douglas F. Gansler announced today that Latia L. Matthews, 24, of Windsor Mill, pleaded guilty to one count of misdemeanor neglect of a vulnerable adult in her care. Baltimore County Circuit Court Judge Julie Glass accepted the guilty plea and scheduled a sentencing hearing for September 23.
July 14, 2014; New Hampshire Attorney General: State v. Stephanie Russell
Attorney General Joseph A. Foster announces that Stephanie Russell of Salisbury, Massachusetts, pleaded guilty and was sentenced on July 14, 2014 to one misdemeanor count of dealing in or possessing a prescription drug. Between January 1, 2013 and October 4, 2013, while Ms. Russell was working as a licensed medication nursing assistant at Saint Ann Rehabilitation and Nursing Center in Dover, she gave a resident of the nursing center a quantity of the drug lorazepam, which came from Ms. Russell's personal prescription.
July 11, 2014; Connecticut State Attorney Office: Hartford Woman Charged With Forgery, Unlawfully Practicing Nursing
A Hartford woman who continued to work after her nursing license was suspended was arrested today and charged with unlawfully practicing nursing and forgery. Samantha Colbert, age 30, of Westland Street, Hartford, was arrested by Inspectors from the Medicaid Fraud Control Unit in the Office of the Chief State's Attorney and charged with one count of unlawfully practicing nursing and one count of Forgery in the Second Degree.
July 11, 2014; Tennessee Department of Finance & Administration: Cocke Co. Couple Charged With TennCare Doctor Shopping
NASHVILLE, Tenn. - A husband and wife from Cocke County are each charged with TennCare fraud involving "doctor shopping," or using TennCare to go to multiple doctors in a short time period to obtain prescriptions for a controlled substance. The Office of Inspector General, with assistance from Cocke and Hamblen County Sheriff's Officers, today announced the arrests of Terra Keller, 33, and William Thomas, 34, both from Newport.
July 10, 2014; Mississippi Attorney General: Magee Nursing Home Resident Arrested in Death of Roommate
A nursing home resident in Magee has been arrested for second degree murder involving the death of his roommate, announced Attorney General Jim Hood today. Jerrell Eubanks, 63, a resident of a nursing center in Magee, was arrested this evening by investigators with the Attorney General's Medicaid Fraud Control Unit, with assistance from the Magee Police Department. Eubanks is charged with second degree murder for the death of his roommate at the nursing home.
July 10, 2014; New York Attorney General: Westchester Medical Transport Company Owner Arrested On Felony Theft Charges In Medicaid Fraud
PEARL RIVER - Attorney General Eric T. Schneiderman today announced the arrest of Kurien Palliankal, the owner of New Rochelle-based transportation company Carewell Ambulette, Inc., on felony charges for allegedly stealing more than $200,000 from the Medicaid program. The individual and his company are charged with altering transportation requests sent to them by medical facilities authorizing taxi pickups and dropoffs for Medicaid patients. The defendants are charged with doctoring the requests during a four year period to claim requests for ambulette service, which is paid by Medicaid at a rate four times higher than for taxis.
July 10, 2014; Arkansas Attorney General: Marion County Woman Pleads Guilty To Medicaid Fraud
LITTLE ROCK - A Marion County woman pleaded guilty today to felony Medicaid fraud for billing the state's Medicaid program for services she did not provide, Attorney General Dustin McDaniel announced. Amanda Coker, 36, of Yellville was convicted in Pulaski County Circuit Court on one count of Medicaid Fraud, a Class B felony. Special Circuit Judge John Plegge sentenced Coker to five years of probation. She was ordered to pay a fine of $10,357.95 and restitution of $3,452.65.
July 9, 2014; New Jersey Attorney General: Three Home Health Aides Indicted on Multiple Counts of Health Care Claims Fraud
TRENTON - Acting Attorney General John J. Hoffman announced that two employees of a home health agency and one former employee of the agency were charged today in separate indictments for allegedly causing bills to be submitted to the Medicaid program for services that were never provided. All three were certified homemaker home health aides at Confident Care Corporation, a company that is headquartered in Hackensack and has ten satellite offices throughout New Jersey, as well as offices in Florida.
July 9, 2014; Oklahoma Attorney General: Attorney General Pruitt Charges Licensed Professional Counselor in Fraudulent Billing While At Local
OKLAHOMA CITY- Attorney General Scott Pruitt's Medicaid Fraud Control Unit filed charges against a counselor at Oklahoma Counseling Services (OCS). The charged counselor turned herself over to local authorities Wednesday morning. Annie G. King, 41, of Pryor, a licensed professional counselor providing mental health services, was charged with three counts of Medicaid fraud.
July 9, 2014; Tennessee Department of Finance & Administration: Georgia Woman Charged With TennCare Fraud
NASHVILLE, TN - A Georgia woman is charged with claiming she lived in Tennessee in order to obtain TennCare healthcare insurance benefits. The Office of Inspector General today announced the arrest of Xochitl Gomez, 47, of Rossville, Georgia. Gomez is charged in an indictment with TennCare fraud and theft of property. The indictment accuses her of falsely reporting to the state that she and her children resided in Tennessee, in order to be eligible for TennCare benefits, when they actually live in Rossville, Georgia.
July 8, 2014; Kentucky Attorney General: AG Conway Announces Sentencing of Former CDO Employee
Attorney General Jack Conway and his Medicaid Fraud and Abuse Control Unit today announced the sentencing of a former Consumer Directed Options (CDO) employee on charges involving theft and fraud. On May 20, William Qualls, 22, pleaded guilty in Jefferson Circuit Court to theft by unlawful taking under $10,000 and devising or engaging in a scheme to defraud the Kentucky Medicaid program. Qualls was sentenced today and received a three-year sentence, which will be probated for a period of five years. He was also ordered to repay $3,076.50 to the Kentucky Department of Medicaid Services.
July 8, 2014; Maryland Attorney General: Charles County Man Sentenced In Medicaid Fraud Case; Licensed Clinical Counselor Submitted False Claims For Services Never Provided
Baltimore, MD - Attorney General Douglas F. Gansler announced today that Leon Wilson, 54, of Waldorf, has been found guilty of felony Medicaid Fraud, having billed the program for services he did not provide. Prince George's County Circuit Court Judge Nicholas E. Rattal sentenced Wilson to three years incarceration, all of which is suspended. Wilson was placed on three years of supervised probation, ordered to pay $5,069.88 in restitution and perform 100 hours of community service.
July 8, 2014; Louisiana Attorney General: Brother-Sister Duo Arrested in Medicaid Fraud Billing Scheme
Siblings Cleveland and Barbara Smith have been arrested for a scheme aimed at falsely billing the state's Medicaid program, announced agents with the Louisiana Attorney General's Medicaid Fraud Control Unit (MFCU).
July 8, 2014; Tennessee Department of Finance & Administration: Obion Co. Man Charged With TennCare Fraud Found In Mississippi
NASHVILLE, TN - An Obion County man is charged in McNairy County with TennCare fraud for falsely reporting his income in order to obtain TennCare benefits. The Office of Inspector General today announced the arrest of Charles E. Oathout, 43, of Union City. He is charged with TennCare fraud and theft of services in McNairy County, where a Grand Jury issued the charges last month. Oathout fled the state and was found residing in Alcorn County, Mississippi. Once he was located, he was returned to Tennessee to be served with the charges.
July 2, 2014; Idaho Attorney General: Idaho Petitions U.S. Supreme Court to Hear Medicaid Reimbursement Rate Case
(Boise) - Idaho Attorney General Lawrence Wasden is asking the U.S. Supreme Court to consider the state's appeal of a lawsuit challenging the Medicaid reimbursement rates paid to providers.
July 2, 2014; Tennessee Department of Finance & Administration: Maury Co. Woman Charged With TennCare Fraud
NASHVILLE, TN - A Maury County woman is charged with TennCare fraud in connection with falsely reporting her income to the state, in order to obtain healthcare insurance benefits through TennCare, the state's Medicaid managed care program. The Office of Inspector General, with the assistance of the Maury County Sheriff's Office, today announced the arrest of Susan R. Morton, 41, of Columbia.
July 1, 2014; Vermont Attorney General: Personal Care Assistant Convicted For Submitting False Timesheets
Brooke Scott, age 25, of South Hero, Vermont, was convicted on June 26, 2014, in the Windsor Criminal Division of the Vermont Superior Court, of six misdemeanor counts of False Pretenses. The convictions stemmed from Mr. Scott's submission of false timesheets in order to obtain payment for services that were not provided to a child with special needs enrolled in the Children's Personal Care program, a Vermont Medicaid program.
July 1, 2014; Alabama Attorney General: AG Announces Conviction of Former Conecuh County Nursing Home Bookkeeper for Theft of Residents' Funds
(MONTGOMERY)--Attorney General Luther Strange announced the conviction today of Mary K. Nowell for the theft of patient funds from Evergreen Nursing Home and Rehabilitation in Conecuh County.
July 1, 2014; Georgia Attorney General: Owner of Speech Therapy Company Sentenced to Prison for Medicaid Fraud
Former Georgia Medicaid provider Timothy Robinson was sentenced today by Cobb Superior Court Judge A. Gregory Poole to two years in prison, followed by eight years probation, for submitting fraudulent bills to Georgia Medicaid totaling over $582,000. Robinson pleaded guilty to one count of Medicaid Fraud on April 17, 2014.
July 1, 2014; Mississippi Attorney General: Jackson Resident Going to Prison for Medicaid Fraud
A Jackson resident is going to prison for Medicaid fraud, announced Attorney General Jim Hood today. Barbara Jones, 31, of Jackson, pleaded guilty to three counts of Medicaid fraud before Hinds County Circuit Court Judge Jeff Weill today. As a result, Jones was sentenced to five years in the custody of the Mississippi Department of Corrections, one to serve, four suspended and five years of post release supervision per count to run concurrently. Jones was also ordered to pay $28,158.61 in restitution and a penalty of $84,475.83, to be paid during the five years of post release supervision.
July 1, 2014; Mississippi Attorney General: Jackson Resident Going to Prison for Abuse of Vulnerable Person
A Jackson resident is going to prison for felony abuse of a vulnerable person, announced Attorney General Jim Hood today. Joshua Mitchell, 23, of Jackson, pled guilty to felony abuse of a vulnerable person Monday in front of Judge William E. Chapman in Rankin County Circuit Court. As a result, Judge Chapman sentenced Mitchell to 10 years in the custody of the Mississippi Department of Corrections, five years suspended, five to serve followed by five years of supervised probation. Mitchell was also ordered to pay $1,000 to the Mississippi Crime Victim Compensation Fund and court costs of $931.50.

June 2014

June 30, 2014; New York Medicaid Office of Inspector General: Nassau Doctor Denied Medicaid Reinstatement
A Nassau County physician, Mark Shaffer, was denied reinstatement into the New York State Medicaid program following an evaluation of his application by the New York State Office of the Medicaid Inspector General. This denial was based on concerns about his past behavior which had included failure to maintain patient records, allowing unqualified staff to administer inoculations, and filing false reports with the aim of inflating insurance reimbursements.
June 30, 2014; Tennessee Department of Finance & Administration: Knox Co. Woman Charged With Doctor Shopping For Drugs
NASHVILLE, TN - A Knox County woman is charged in nearby Anderson County with TennCare fraud involving "doctor shopping," or using TennCare to go to multiple doctors to obtain prescriptions for a controlled substance. The Office of Inspector General with assistance from state Department of Correction officers and the Anderson County Sheriff's Department, today announced the arrest of Rachael Christine Presnell, 25, of Knoxville. She is charged with fraudulently using TennCare to obtain a controlled substance by "doctor shopping" for controlled substances, and using TennCare as payment. In addition, Presnell is charged with obtaining a controlled substance by fraud.
June 27, 2014; New York Attorney General: A.G. Schneiderman Announces Lawsuit against Continuum Health Partners, Beth Israel Medical Center and St. Luke's-Roosevelt
NEW YORK - Attorney General Eric T. Schneiderman today announced that his office has filed a lawsuit alleging that Continuum Health Partners, Inc., Beth Israel Medical Center and St. Luke's-Roosevelt Hospital Center, headquartered in New York, failed to return money to the New York State Medicaid Program that they knew they had no right to have received.
June 27, 2014; Ohio Attorney General: Ohio Attorney General DeWine Announces Indictment Against Nursing Home, Owner
Ohio Attorney General Mike DeWine today announced that a special grand jury has indicted the owner of a Zanesville nursing home, as well as the nursing home itself, on multiple charges, including Engaging in a Pattern of Corrupt Activity.
June 27, 2014; Connecticut State Attorney Office: APRN to Serve 23 Years in Sexual Assault, Medicaid Fraud Cases
An advanced practice registered nurse (APRN) was sentenced today to serve 23 years in prison on sexual assault and Medicaid fraud charges involving child victims. Jay T. Mohler-Avery, of 25 Mountain Street, Hartford, pled guilty in the Superior Court for the Judicial District of Tolland to one count each of Sexual Assault in the First Degree and Risk of Injury to a Minor and two counts of Conspiracy to Commit Sexual Assault in the First Degree. He also pled no contest to one count of Insurance Fraud for billing the state's Medicaid program for a bogus medical appointment where he sought to arrange sexual relations with an infant child.
June 26, 2014; Vermont Attorney General: Personal Care Assistant Convicted For Submitting False Timesheets
Kammy McDonald, age 43, of Winooski, Vermont, was convicted on June 24, 2014, in the Windsor Criminal Division of the Vermont Superior Court, of five misdemeanor counts of False Pretenses. The convictions stemmed from Ms. McDonald's submission of false timesheets in order to obtain payment for services that were not provided to an adult with physical disabilities enrolled in the Choices for Care program.
June 26, 2014; Tennessee Department of Finance & Administration: Wilson Co. Woman Charged In Plot To Make Relative Eligible Fort TennCare
NASHVILLE, TN - A Wilson County woman is charged in Trousdale County with TennCare fraud in connection with taking over a relative's assets so the state would pay for the relative's nursing home care. The Office of Inspector General, with the assistance of the Trousdale County Sheriff's Office, today announced the arrest of Angela Douglas, 45, of Mt. Juliet. In a three-count indictment, Douglas is accused of transferring her grandfather's assets and resources to herself, using power of attorney, in order to make him eligible for TennCare benefits, which would include nursing home care.
June 25, 2014; New York Medicaid Office of Inspector General: Ambulette company overbilled Medicaid by more than $2.48 million
Reliance Ambulette, a Flushing, New York -based provider of medical transportation services, overbilled the Medicaid program by $2,487,129 during a two-year period, according to a recent audit (#08-1781) completed by the New York State Office of the Medicaid Inspector General (OMIG) in conjunction with the New York City Human Resources Administration. The audit cites the company for lack of compliance with standards required by the Medicaid program. The audit was conducted under the auspices of the County Demonstration Program, a joint state and local partnership, overseen by OMIG.
June 23, 2014; Georgia Attorney General: Three More Defendants Sentenced in Cobb County Medicaid Fraud Scheme
Lisa N. Hankerson and Pierre A. Hixon pleaded guilty to Racketeering, Medicaid Fraud, and Conspiracy to Defraud the State today in Cobb County Superior Court. Hankerson, Hixon, and their co-defendants obtained over $622,000 through the fraudulent billing of Georgia Medicaid and the Amerigroup Corporation. Between July 2005 and June 2010, Hankerson was the primary Medicaid biller for First Step Counseling Services, Inc. of Marietta, which provided Intensive Family Intervention counseling services, as well as Family and Individual counseling services, to troubled children in need of intensive therapy for behavioral issues. Children who qualify for these services under Medicaid typically do so because they are in danger of being removed from their homes. Hankerson is also the wife of First Step co-owner and co-defendant Garry Hankerson, who was sentenced on June 12, 2014, to serve seven years in prison and ordered to pay $622,125.43 in restitution. Hixon was a co-owner of First Step Counseling Services and served as its head of clinical services.
June 23, 2014; New York Attorney General: A.G. Schneiderman Announces Sentencing Of Buffalo Man Who Collected Over $100,000 Operating As An Unlicensed Optometrist In Rochester
ROCHESTER - Attorney General Eric T. Schneiderman today announced the sentencing of Shamil Tadros, 45 years old, of Tonawanda, New York, on charges related to fraudulently operating as an optometrist and providing ophthalmic dispensing services without a license for either profession. Tadros, who attended optometry school but has not passed the state exams required to obtain licensure, runs Pittsford Optical in Pittsford, New York. Tadros was sentenced by Acting County Court Judge Melchor Castro in Monroe County Court to a 3 year conditional discharge with the following conditions: to pay back $116,821 in criminal restitution, to complete 150 hours of community service, and to consent to random practice checks of his optical shop. Tadros pled guilty on January 16, 2014 where he admitted to engaging in a fraudulent scheme that occurred from on or about January 1, 2000 to May 31, 2013, where he billed Medicaid and other payers for ophthalmology services. As a result of his criminal conduct, Tadros illegally obtained $116,821 from the State of New York and several other health insurers. Tadros has paid the full $116,821 in restitution and completed the required 150 hours of community service prior to sentencing.
June 23, 2014; New York Attorney General: A.G. Schneiderman Announces Arrest Of Westchester Nurse And Nurse Aide For Failure To Provide Care To Ailing Korean War Veteran In Their Care
PEARL RIVER - Attorney General Eric T. Schneiderman today announced the arrest and arraignment of Joyce Opoku, a licensed practical nurse, and Isabelle Todman, a certified nurse aide, on charges they failed to provide proper care to an 84-year-old resident of the New York State Veterans' Home at Montrose and for making false statements in the resident's medical records to falsely reflect that they had provided the care. The victim, a Korean War veteran who suffered from dementia and Parkinson's disease, was found on the floor of his room at about 6:15 a.m. on the morning of May 1, 2013 and was pronounced dead shortly thereafter. The Attorney General's Medicaid Fraud Control Unit, in cooperation with the Veterans' Home, which is operated by the New York State Department of Health, conducted an investigation and determined that Opoku and Todman failed to properly check on him overnight.
June 20, 2014; Oklahoma Attorney General: Child Counselor Charged with Medicaid Fraud
OKLAHOMA CITY- Attorney General Scott Pruitt has filed charges in Oklahoma County District Court against a licensed professional counselor after investigators found false claims for Medicaid reimbursement. Vincent Chukunenye Dike, 58, of Edmond, was charged Tuesday with one count of Medicaid fraud. His bail was set at $114,000 and he surrendered his passport. The AG's Medicaid Fraud Control Unit also charged Dike with 10 counts of Medicaid fraud in December for claims that totaled more than $60,000.
June 19, 2014; New Jersey Attorney General: Owner of Numerous MRI Centers and Twelve Others Arrested in Scheme That Allegedly Paid Hundreds of Thousands of Dollars in Illegal Kickbacks to Doctors in Exchange for Patient Referrals
TRENTON - Acting Attorney General John J. Hoffman announced that the Office of the Insurance Fraud Prosecutor, Medicaid Fraud Control Unit, arrested the owner of a network of diagnostic imaging centers for his alleged role as the leader of a criminal enterprise that provided hundreds of thousands of dollars in illegal kickbacks to medical practitioners in exchange for patient referrals to his testing facilities. In addition, the defendants allegedly submitted fraudulent applications to the New Jersey Medicaid program and Department of Health, and evaded paying income and franchise taxes, among other illegal activities. The enterprise allegedly generated millions of dollars in illegal profits. Twelve others were also charged in the alleged scheme.
June 18, 2014; Tennessee Department of Finance & Administration: Davidson Co. Man Charged With TennCare Drug Fraud
NASHVILLE, TN - A Davidson County man is charged with TennCare fraud for selling his prescription drugs, which were paid for by the state's TennCare program. The Office of Inspector General, with assistance from Metro Nashville Police, today announced the arrest of Robert Carlton Patterson, 51, of Nashville. He is charged with TennCare fraud for the sale or delivery of the painkiller Oxycodone, obtained through the use of his TennCare benefits.
June 18, 2014; Tennessee Department of Finance & Administration: Davidson Co. Woman Charged With TennCare Drug Fraud
NASHVILLE, TN - A Davidson County woman is charged with selling drugs prescribed to her minor child, which had been obtained through TennCare, the state's Medicaid healthcare insurance program. The Office of Inspector General, with assistance from Metro Nashville Police, today announced the arrest of Sara Lynn White, 34, of Nashville. White is charged with TennCare fraud and child neglect in an indictment accusing her of selling a portion of a drug prescribed for her minor child. The drug, Vyvanse, a stimulant used to treat attention deficit hyperactivity disorder, was obtained through TennCare benefits.
June 18, 2014; Alabama Attorney General: AG Announces Arrest of Southwest Alabama Dentist; Partner Pleaded Guilty to Similar Medicaid Fraud Charges
(MONTGOMERY) Attorney General Luther Strange announced the arrest today of a Southwest Alabama dentist on charges of Medicaid fraud for actions to which his partner pleaded guilty last week. Dr. William Britt Morris surrendered this morning to the Montgomery County Sheriff's Office and was released on $30,000 bond. Dr. Jimmy C. White was convicted on June 11. The two dentists have offices in Butler and Grove Hill.
June 18, 2014; Connecticut State Attorney Office: Stamford Dentist Charged With Defrauding Medicaid Program
A Stamford dentist was arrested today and charged with billing Medicaid for dental services that were never provided. GEORGY BETSER, age 71, of Summer Street, Stamford, was arrested by Inspectors from the Medicaid Fraud Control Unit in the Office of the Chief State's Attorney and charged with one count each of Larceny in the First Degree by Defrauding a Public Community and Insurance Fraud.
June 18, 2014; Connecticut State Attorney Office: Fairfield Dentist Charged with Violating Medicaid Ban
A Fairfield dentist who was barred by the federal government from participating in Medicaid was arrested today and charged with continuing to bill and receive payments from the government health care program. PAUL DENGELEGI, age 51, of Lockwood Circle, Fairfield, was arrested by Inspectors from the Medicaid Fraud Control Unit in the Office of the Chief State's Attorney and charged with one count each of Larceny in the First Degree by Defrauding a Public Community and Insurance Fraud.
June 17, 2014; Tennessee Department of Finance & Administration: Davidson Co. Woman Charged With TennCare Doctor Shopping
June 16, 2014; New York Attorney General: A.G. Schneiderman Announces $115,094 Settlement with SUNY for Excess Medicaid Payment
BUFFALO - Attorney General Eric T. Schneiderman today announced that his Medicaid Fraud Control Unit (MFCU) has reached a Memorandum of Understanding with the State University of New York (SUNY) to recover $115,094 in excess Medicaid payments for dental services performed from January 1, 2005, through August 31, 2009, at the Daniel Squire Oral Diagnostic & Treatment Center on the University's Main Street campus in Buffalo.
June 16, 2014; Tennessee Department of Finance & Administration: Sullivan Co. Man Must Repay State After Conviction On TennCare Fraud
NASHVILLE, TN - A Sullivan County man has been ordered to repay the state after his conviction on TennCare fraud charges. The Office of Inspector General announced sentencing for 39-year old George Dease, Jr, of Kingsport. He was arrested by the OIG in August of last year, when he was charged with TennCare fraud and two counts of theft of services.
June 16, 2014; Tennessee Department of Finance & Administration: Davidson Co. Woman Charged With Doctor Shopping
NASHVILLE, TN - A Davidson County woman is charged with TennCare fraud involving "doctor shopping," or using TennCare to go to multiple doctors in a short time period to obtain prescriptions for a controlled substance. The Office of Inspector General, with help from Metro Nashville Police, today announced the arrest of Tyniki T. Graham, 39, of Hermitage. She is charged with six counts of fraudulently using TennCare to obtain a controlled substance by "doctor shopping," obtaining prescriptions for the painkillers Hydrocodone and Tramadol, with the prescriptions or the clinical visits being paid for by TennCare.
June 16, 2014; Tennessee Department of Finance & Administration: Hamblen Co. Man Charged With Doctor Shopping
NASHVILLE, TN - A Hamblen County man is charged with TennCare fraud involving "doctor shopping," or using TennCare to go to multiple healthcare providers in a short period of time to obtain controlled substances. The Office of Inspector General, with the assistance of the Hamblen County Sheriff's Office, today announced the arrest of Brian Hedrick, 43, of Morristown. He is charged with six counts of fraudulently using TennCare to obtain controlled substances by "doctor shopping." Hedrick used TennCare benefits to pay for the clinical visits or for payment of the controlled substances.
June 16, 2014; Tennessee Department of Finance & Administration: Hamilton Co. Woman Charged With Doctor Shopping
NASHVILLE, TN - A Hamilton County woman is charged with TennCare fraud involving "doctor shopping," or going to multiple doctors in a short period of time to obtain prescription drugs and using TennCare as payment. The Office of Inspector General with the assistance of the Hamilton County Sheriff's Office, today announced the arrest of Jama Denise Burton also known as Jama Denise Miller, 42, of Harrison. Miller is charged with eight counts of fraudulently using TennCare to obtain controlled substances by "doctor shopping." She is also charged with eight counts of obtaining a controlled substance by fraud.
June 13, 2014; Georgia Attorney General: Marietta Man Sentenced to Seven Years in Prison for Medicaid Fraud
On Thursday, June 12, 2014, Garry A. Hankerson, Jr. pleaded guilty to Racketeering, Medicaid Fraud, and Conspiracy to Defraud the State in Cobb County Superior Court. Hankerson and his co-defendants obtained over $622,000 through the fraudulent billing of Georgia Medicaid and the Amerigroup Corporation. Hankerson is the co-owner of First Step Counseling Services, Inc. of Marietta, which provided Intensive Family Intervention counseling services as well as Family and Individual counseling services to troubled children in need of intensive therapy for behavioral issues. Children who qualify for these services under Medicaid typically do so because they are in danger of being removed from their homes. Between July 2005 and June 2010, Hankerson and his accomplices would use their patient's Medicaid numbers to bill far in excess of the services provided, sometimes billing when children were no longer in the State of Georgia. Some patients reported being seen only twice, while First Step billed for hundreds of counseling sessions. In sum, over 3,000 false claims were identified over a five year period.
June 13, 2014; Kentucky Attorney General: Former Owner of Caregiving Service Pleads Guilty to Medicaid Fraud
Attorney General Jack Conway and his Office of Medicaid Fraud and Abuse Control today announced that the former owner and operator of an in-home caregiving service has pleaded guilty to engaging in or devising a scheme to defraud the Kentucky Medicaid program. Sheryl Bruner, 51, entered the plea this morning in Fayette Circuit Court. Bruner chose to waive her right to a grand jury indictment and was instead charged by a single-count criminal information. Bruner was the owner and operator of Support Source, Inc., which had an office in Lexington and was also managed by Bruner from her Nicholasville home. Support Source purportedly provided in-home care to disabled patients via Medicaid-funded waiver services. After Support Source's Medicaid funding was suspended by the Cabinet for Health and Family Services in 2011 following an investigation by the Office of the Inspector General, Bruner continued her scheme by retaining many of her patients and transferring them to a different company based in Lee County.
June 12, 2014; Connecticut State Attorney Office: Non-Existent Job Allegedly Nets $9,000 Medicaid Fraud
A West Hartford man was arrested today and charged with concocting a scheme that netted him more than $9,000 in wages supposedly paid to a Norwich woman for a non-existent job she knew nothing about. Troy D. Williams, age 40, of 186 South Highland Street, West Hartford, was arrested by Inspectors from the Medicaid Fraud Control Unit in the Office of the Chief State's Attorney and charged with one count each of Larceny in the First Degree by Defrauding a Public Community, Forgery in the Second Degree and Insurance Fraud.
June 12, 2014; Louisiana Attorney General: New Iberian Woman Arrested for Medicaid Fraud
A New Iberia woman was arrested today and charged with two counts of Medicaid fraud for causing the filing of false claims, announced the Louisiana Attorney General's Medicaid Fraud Control Unit. Theresa Clay Guy, 38, of 719 Westend Boulevard, surrendered to investigators from the Attorney General's Medicaid Fraud Control Unit on Thursday. Guy was booked into the East Baton Rouge Parish Prison.
June 11, 2014; Iowa Attorney General: Judge Finds Nebraska Owner of Western Iowa Care Centers and Husband Guilty of Contempt, Orders Three Months in Jail
(DES MOINES, Iowa) An Iowa judge Tuesday ordered a Nebraska couple to serve ninety days in jail on contempt charges after the judge ruled the two violated a court order preventing them from transferring property connected to an alleged $3-million-dollar Medicaid debt.
June 11, 2014; Florida Attorney General: Attorney General Bondi's Office Arrests Unlicensed Mental Health Counselor for Medicaid Fraud
TALLAHASSEE, Fla. - Attorney General Pam Bondi's Medicaid Fraud Control Unit arrested Palm Beach County man Richard Robert Day, 70, following allegations that he practiced mental health counseling without a valid license and defrauded the Medicaid program. According to the investigation, Day was employed by Brevard County nursing home MTS Health Services, LLC, where he forged a mental health counseling license to secure employment. As an unlicensed counselor, Day caused fraudulent billings of more than $9,000 to the Medicaid program.
June 10, 2014; Kansas Attorney General: Parsons woman ordered to repay nearly $20,000 for Medicaid fraud
PARSONS - A Parsons woman was ordered today to repay $19,704 to the Kansas Medicaid program after pleading no contest to eight charges of Medicaid fraud. Ginger Wilson, 45, pleaded no contest in February to multiple charges of conspiracy to make false statements to the Medicaid program, making false statements to the Medicaid program and unlawful acts involving the Medicaid program.
June 10, 2014; Tennessee Department of Finance & Administration: Four Convicted Of TennCare Fraud
NASHVILLE, TN - Four people convicted of TennCare fraud have been sentenced in Marshall, Hamblen, Davidson and Shelby Counties. The Office of Inspector General today announced the sentencing of people previously charged in TennCare fraud cases: Marshall County: Gena Leigh Garton, 33, of Chapel Hill, pleaded guilty to TennCare fraud and theft of services. She received a four-year judicial diversion and was ordered to pay restitution to TennCare in the amount of $3,033. Hamblen County: Brandon Trent, 25, of Rogersville, pleaded guilty to TennCare fraud and was sentenced to one year in prison, suspended to one year of probation. He was ordered to pay $762.59 in restitution and $100 in fines. Davidson County:Griselda Castaneda-Camacho, 29, of Nashville, pleaded guilty to four counts of TennCare fraud and received one year of supervised probation under judicial diversion. Castaneda-Camacho was also ordered to pay $764.33 in restitution. Shelby County: Tamara Spears, 40, of Walls, Mississippi, pleaded guilty to theft of property and received four years of supervised probation under judicial diversion. Spears was ordered to pay $28,782.63 in restitution, with $5,000 of it to be paid within 15 days.
June 9, 2014; Tennessee Department of Finance & Administration: Three In West Tenn. Charged With TennCare Fraud
NASHVILLE, TN - Three people in West Tennessee are charged with TennCare fraud in separate cases out of Ripley and New Johnsonville, Tennessee. The Office of Inspector General, with the assistance of the New Johnsonville Police Department and the Lauderdale County Sheriff's Office, today announced the arrests: Ashley D. Forrest, 27, of New Johnsonville, who is accused of TennCare fraud for receiving benefits through the state's Medicaid program that she was not entitled to receive. Larrisa Bishop, 24, of Ripley, charged with three counts of fraudulently using TennCare to obtain controlled substances by "doctor shopping," using TennCare as payment. Sheila Coker, 44 of Ripley, charged with TennCare fraud, possession of the painkiller Morphine with intent to deliver, delivery of a Schedule II controlled substance and delivery of a Schedule III controlled substance. Coker is accused of using TennCare benefits to obtain the painkillers Morphine and Hydrocodone, later selling a portion of the drugs.
June 6, 2014; New Jersey Attorney General: Former Ocean County Doctor Charged with Practicing Medicine without a License
TRENTON - Acting Attorney General John J. Hoffman announced that detectives with the Office of the Insurance Fraud Prosecutor, Medicaid Fraud Control Unit (MFCU) executed a search warrant at an Ocean County medical clinic this morning and charged a former doctor with practicing medicine without a license.
June 6, 2014; U.S. Attorney; District of Columbia and Officer of Inspector General; District of Columbia: Former District of Columbia Government Employee Sentenced to 20 Months in Prison for $783,876 Fraud Scheme
WASHINGTON - Aretha Holland-Jackson, a former employee of the District of Columbia Department of Human Services (DHS), was sentenced today to 20 months in prison for carrying out a scheme that defrauded the government of more than $780,000 in Medicaid, food stamp, and other benefits, announced U.S. Attorney Ronald C. Machen Jr. and Blanche L. Bruce, Interim Inspector General of the District of Columbia.
June 6, 2014; Tennessee Department of Finance & Administration: McMinnville Woman Arrested For TennCare Fraud
NASHVILLE, TN - A woman charged with TennCare fraud has been apprehended after eluding authorities for over a year. The Office of Inspector General, with the assistance of the DeKalb County Sheriff's Office, today announced the arrest of Julie D. Wright, 36, of McMinnville. She was charged in an indictment in April of 2013 with TennCare fraud in connection with obtaining a controlled substance paid for by TennCare, while planning to sell a portion of the drugs.
June 6, 2014; Kansas Attorney General: Lawrence woman to repay $11,000 for Medicaid fraud
LAWRENCE - A Lawrence woman must repay more than $11,000 after being found guilty of Medicaid fraud, Kansas Attorney General Derek Schmidt said. Penny Miller, 49, today pleaded no contest to one count of making a false claim to the Medicaid program.
June 5, 2014; Louisiana Attorney General: 8 Arrested in Medicaid Fraud Conspiracy
Eight people have been arrested after it was discovered that a personal care services company conspired with its Medicaid recipients to steal Medicaid dollars, announced the Louisiana Attorney General's Medicaid Fraud Control Unit. The Donaldsonville-based licensed Medicaid provider, Majestic Home Care Services, LLC, owned by Latesha Taylor and operated jointly with her mother, Martha Taylor, repeatedly billed Louisiana's Medicaid program for services not actually rendered to Medicaid recipients.
June 5, 2014; New York Attorney General: A.G. Schneiderman Announces Indictment Of Nine Suffolk County Nursing Home Employees In Connection With Resident Death
NEW YORK - Attorney General Eric T. Schneiderman today announced the indictment of nine employees of the Medford Multicare Center for Living, Inc. in Medford, New York, including the facility's top administrator. Seven of those indicted were arrested and charged earlier this year in connection with the death of a 72-year-old resident who was at the nursing home for what was supposed to be temporary rehabilitation. Two employees, Marianne Fassino and Leona Gordon, were arrested today. All nine defendants were arraigned on the newly filed indictment before Suffolk County Supreme Court Justice John B. Collins. In addition, the corporation operating the home was indicted on charges of attempting to cover up the circumstances surrounding the 2012 death.
June 5, 2014; New York Attorney General: Kingston Nurse Charged With Failure To Give Life-saving Care To Nursing Home Resident
PEARL RIVER - Attorney General Eric T. Schneiderman today announced the arrest of Patricia Smithmyer, a registered and supervising nurse at Golden Hill Care Center in Kingston, who failed to follow the wishes of an 80-year-old resident and the directive of the nursing home by failing to administer CPR when the resident stopped breathing. The failure to offer life-saving care came despite requests from the resident and her family that life-saving procedures be used if the need arose.
June 4, 2014; Florida Attorney General: Indian River County Certified Nursing Assistant Arrested for Battery of a Senior Citizen
TALLAHASSEE, FL - Attorney General Pam Bondi's Medicaid Fraud Control Unit and the Indian River County Sheriff's Office arrested Sebastian resident Lawrence Michael Frazier, 52, for battery of a senior citizen. The Attorney General's Medicaid Fraud Control Unit's Patient Abuse, Neglect and Exploitation (PANE) team began the investigation after receiving information from the Florida Department of Children and Families. Frazier was employed as a certified nursing assistant by Clare Bridge of Vero Beach, an Alzheimer and dementia care facility for seniors. The investigation revealed that a co-worker allegedly observed Frazier striking an 87-year-old resident in the face.
June 4, 2014; U.S. Attorney; Northern District of Ohio & Ohio Attorney General: Husband, Wife Sentenced to Prison on Health Care Fraud Charges, Must Repay More than $800,000
Ohio Attorney General Mike DeWine and U.S. Attorney for the Northern District of Ohio Steven M. Dettelbach announced today that the husband and wife owners of a Maple Heights ambulette company will each serve time in prison for fraudulently billing Medicaid for hundreds of thousands of dollars of transportation services that they did not actually provide.
June 3, 2014; Florida Attorney General: Duval County Resident Arrested for Medicaid Fraud
TALLAHASSEE, Fla.-An investigation led by Attorney General Pam Bondi's Medicaid Fraud Control Unit culminated late yesterday afternoon with the arrest of Ashley Vyktoria Tullon, 27, for Medicaid fraud, a third degree felony. The Jacksonville Sheriff's Office and the Medicaid Fraud Control Unit took Tullon into custody, following an investigation that revealed Tullon billed Medicaid for services never rendered.
June 3, 2014; Tennessee Department of Finance & Administration: Knox Co. Man Charged With Doctor Shopping
NASHVILLE, TN - A Knox County man is charged with TennCare fraud involving "doctor shopping," or using TennCare to go to multiple doctors in a short time period to obtain controlled substances. The Office of Inspector General, with the assistance of the Knox County Sheriff's Office, today announced the arrest of Jonathan Dale Presnell, 33, of Knoxville.

May 2014

May 30, 2014; Tennessee Department of Finance & Administration: Putnam Co. Woman Charged With Doctor Shopping
NASHVILLE, TN - A Putnam County woman is charged with TennCare fraud involving "doctor shopping," or using TennCare to go to multiple doctors in a short time period to obtain controlled substances. The Office of Inspector General, with the assistance of the Putnam County Sheriff's Office, today announced the arrest of Misty Dawn Cook, 38, of Monterey. She is charged with three counts of doctor shopping and three counts of obtaining a controlled substance by fraud. Cook obtained Oxycodone through clinical visits which were paid for by TennCare.
May 28, 2014; New York Attorney General: A.G. Schneiderman Announces Broome County Nurse Arrested For Endangering Nursing Home Resident And Falsifying Records
UNION - Attorney General Eric T. Schneiderman today announced the arraignment of Tanya Johnson, 34, a Licensed Practical Nurse, for failing to follow nursing home policy after a resident fell and injured himself, then lying to the facility about what happened. She was charged with Falsifying Business Records in the First Degree, Endangering the Welfare of an Incompetent or Physically Disabled Person in the Second Degree, and Willful Violation of Health Laws, in the Town of Union Justice Court, Broome County.
May 23, 2014; Oklahoma Attorney General: Operators of Mental Health Care Facility Charged with Medicaid Fraud
OKLAHOMA CITY - Attorney General Scott Pruitt Wednesday filed charges in Oklahoma County District Court against the operators of Central Oklahoma Behavioral Health Services, LLC. John Michael Doneti, 50, of Oklahoma City, and Angelique Marie Williamson, 39, of Choctaw, were each charged with five counts of Medicaid fraud, one count of identity theft, one count of conspiracy to commit Medicaid fraud, one count of engaging in transactions involving unlawful proceeds and one count of conspiracy to engage in transactions involving unlawful proceeds.
May 23, 2014; Florida Attorney General: Attorney General Pam Bondi's Medicaid Fraud Control Unit and the Pasco County Sheriff's Office Arrest a Tampa Bay Dentist
TALLAHASSEE, Fla. -Attorney General Pam Bondi's Medicaid Fraud Control Unit, with the assistance of the Pasco County Sheriff's Office, arrested Pasco County Dentist Dr. Miranda Smith on charges of Medicaid Provider fraud. Dr. Smith, owner of Smiles and Giggles Dentistry for Children and Adults in Pasco County, allegedly billed Florida's Medicaid program more than $140,000 in dental services which were either unauthorized or not provided.
May 23, 2014; Florida Attorney General: Attorney General Pam Bondi's Medicaid Fraud Control Unit Arrests a Calhoun County Resident for Medicaid Fraud
TALLAHASSEE, Fla. - Today Attorney General Pam Bondi announced the arrest of a Calhoun County resident for Medicaid Fraud. Following an investigation by the Attorney General's Medicaid Fraud Control Unit, Adria Aultman, 37, was taken into custody by the Leon County Sheriff's Office.
May 23, 2014; Florida Attorney General: Attorney General's Office Arrests Gadsden County Man for Abuse of a Disabled Adult
TALLAHASSEE, FL -Attorney General Pam Bondi's Medicaid Fraud Control Unit arrested Gadsden County resident Aaron Alexander Gibson for Abuse of a Disabled Adult. Acting on a referral from the Adult Protective Services Division of the Department of Children and Families Services, the Medicaid Fraud Control Unit launched an investigation into allegations of abuse at Florida State Hospital in Gadsden County. According to the Unit's investigation, Gibson, who was employed at the hospital, shoved and struck a disabled adult resident multiple times.
May 21, 2014; Nevada Attorney General: Attorney General Masto Announces Conviction Of Home Healthcare Worker For Medicaid Fraud
Las Vegas, NV - Attorney General Catherine Cortez Masto announced today Encarnacion Ferrer, 51, of Las Vegas was sentenced for Medicaid Fraud. Ferrer pled guilty to a misdemeanor offense of Medicaid Fraud-Submitting False Claims.
May 21, 2014; Tennessee Department of Finance & Administration: Dyer Co. Man Charged 2nd Time With Doctor Shopping
NASHVILLE, TN - A Dyer County man is charged a second time with TennCare fraud involving doctor shopping, or using TennCare to go to multiple doctors to obtain controlled substances. The Office of Inspector General, with the assistance of the Dyer and Carroll County Sheriff's Offices and Dyersburg Police, today announced the arrest of Donald K. Buckner, Sr., 54, of Dyersburg.
May 21, 2014; Tennessee Department of Finance & Administration: Four Charged In Wilson County With TennCare Drug Fraud
NASHVILLE, TN - Four people are charged with TennCare fraud in Wilson County in connection with selling prescription drugs that were paid for by the state's TennCare program.
May 20, 2014; Florida Attorney General: Attorney General Bondi's Office and the Levy County Sheriff's Office Arrest Levy County Resident for Medicaid Fraud and Kickback Scheme
TALLAHASSEE, Fla.-Attorney General Pam Bondi's Medicaid Fraud Control Unit and the Levy County Sheriff's Office today arrested Levy County resident Carolyn Berryhill, 61, for Medicaid fraud. After receiving a complaint from the Agency for Health Care Administration, Attorney General Bondi's Medicaid Fraud Control Unit investigated Berryhill for aiding and abetting a scheme to bill Medicaid for more than $10,000 in services never provided, as well as taking cash payments in a criminal kickback scheme. The other individual allegedly involved in the kickback scheme is deceased.
May 20, 2014; Massachusetts Attorney General: Lynn Man Pleads Guilty, Sentenced to Jail in Connection with Scheme to Steal From MassHealth
BOSTON - A Lynn man has pleaded guilty and been sentenced to jail for cashing more than $24,500 in transportation reimbursement checks that were fraudulently obtained, Attorney General Martha Coakley announced today.
May 20, 2014; Tennessee Department of Finance & Administration: Franklin Co. Woman Must Repay State After Pleading Guilty To TennCare Fraud
NASHVILLE, TN - A Franklin County woman has been ordered to repay the state for healthcare insurance benefits she received through TennCare, even though she was not eligible for TennCare. Wendy Farrell, 37, of Estill Springs, was ordered by a Rutherford County court to repay the TennCare a total of $25,041.80, after she pleaded guilty to TennCare fraud, a Class E felony, and felony theft of services. She also received four years' probation.
May 19, 2014; Tennessee Department of Finance & Administration: Hardin Co. Woman Charged With Doctor Shopping For Drugs
NASHVILLE, TN - A Hardin County woman is charged in Hardeman County with TennCare fraud involving doctor shopping, or using TennCare to go to multiple doctors to obtain controlled substances. The Office of Inspector General, with the assistance of the Hardin and Hardeman County Sheriff's Offices, today announced the arrest of Teri Lynn Snodgrass, 40, of Crump.
May 19, 2014; Tennessee Department of Finance & Administration: Knox Co. Woman Charged 2nd Time With Doctor Shopping
NASHVILLE, TN - A Knox County woman is facing her second charge of TennCare doctor shopping, or going to multiple doctors to obtain the same or similar controlled substances. The Office of Inspector General today announced the arrest of 47-year old Nancy Elaine Horsley, also known as Nancy Hayes, Nancy Maples, and Nancy Paskel, of Corryton.
May 19, 2014; Tennessee Department of Finance & Administration: Kentucky Woman Charged With TennCare Fraud
NASHVILLE, TN - A Kentucky woman is charged with TennCare fraud and theft of services after she received healthcare insurance benefits through the program, even though she was not eligible for TennCare. The Office of Inspector General today announced the arrest of Angelia Gibbs, 44, of Danville, Kentucky. She is charged with seven counts of TennCare fraud and one count of theft of services over $10,000.
May 16, 2014; Washington Attorney General: Attorney General secures guilty pleas in Medicaid fraud cases totaling $137,000
OLYMPIA - The Attorney General's Office Medicaid Fraud Control Unit (MFCU) recently secured guilty pleas against four healthcare providers in four separate Medicaid fraud cases around the state, bringing more than $137,000 back to the state's Medicaid program.
May 15, 2014; New Jersey Attorney General: Owner of Union County Home Health Aide Agency Charged With Billing Medicaid & Veterans Affairs More Than $100,000 for Services That Were Not Provided
TRENTON - Acting Attorney General John J. Hoffman announced that the owner of a Union County home health aide agency has been charged in a 30-count indictment for allegedly billing Medicaid and the United States Department of Veterans Affairs more than $100,000 for services never rendered. Laurie Provost, 54, of Sea Girt, was indicted yesterday (May 14) on 23 counts of second-degree health care claims fraud, and one count each of second- and third-degree theft by deception, third-degree Medicaid fraud, third-degree health care claims fraud, fourth-degree forgery, and two counts of fourth-degree falsifying or tampering with records.
May 13, 2014; Nevada Attorney General: Attorney General Masto Announces Conviction of Behavioral Health Company Owner for Medicaid Fraud - R. Richardson
Las Vegas, NV - Nevada Attorney General Catherine Cortez Masto announced that Romeeka Naytesa Richardson, 33, of Las Vegas, was sentenced today in a Medicaid fraud case involving the intentional failure to maintain adequate records to support Medicaid claims. Richardson was sentenced for one gross misdemeanor offense of intentional failure to maintain adequate records by District Court Judge Michelle Leavitt. Judge Leavitt sentenced Richardson to 150 days, suspended, performance of 80 hours of community service and payment of $25,000 in restitution, penalties, and costs.
May 8, 2014; Texas Attorney General: State of Texas Files Legal Action to Recover Fraudulent Medicaid Payments from Xerox
AUSTIN - The Texas Attorney General's Office today filed a civil lawsuit in state district court against Xerox Corporation and its wholly owned subsidiary, ACS Healthcare LLC. The State's legal action seeks to recover fraudulent Medicaid payments for orthodontic and dental services that were improperly approved by Xerox.
May 8, 2014; Tennessee Department of Finance & Administration: Five In Weakley Co. Charged With TennCare Fraud
NASHVILLE, TN - TennCare fraud charges have been lodged against five people in Weakley County. The arrests were part of a four-month undercover operation involving officers from Dresden Police, the Weakley County Sheriff's Office, and the Office of Inspector (OIG). All the charges involve people selling prescription drugs.
May 8, 2014; Tennessee Department of Finance & Administration: Davidson Co. Woman Charged With TennCare Doctor Shopping
NASHVILLE, TN - A Davidson County woman is charged with TennCare fraud involving doctor shopping, or using the state's Medicaid healthcare insurance program to visit more than one doctor in a short period of time to
May 7, 2014; Tennessee Department of Finance & Administration: Putnam Co. Woman Sentenced On TennCare Fraud Charge
NASHVILLE, TN - A Putnam County woman has been ordered to repay TennCare for healthcare benefits received when she was fraudulently enrolled in the state's Medicaid insurance program. The Office of Inspector General today announced the court judgment against 33-year old Tara Michelle Manier of Cookeville. She was charged in March 2013 with providing false information in order to qualify for TennCare benefits. After she pleaded guilty, a Putnam County court ordered her to pay restitution in the amount of $15,041.
May 5, 2014; Tennessee Department of Finance & Administration: Alabama Woman Charged With TennCare Fraud
NASHVILLE, TN - A Florence, Alabama, woman is charged with TennCare fraud for claiming to live in Tennessee in order to obtain TennCare healthcare insurance benefits. The Office of Inspector General, with assistance from the Wayne County Sheriff's Office, today announced the arrest of Melissa Burns, 38, of Florence, Alabama.
May 5, 2014; Tennessee Department of Finance & Administration: College Grove Residents Charged With TennCare Fraud
NASHVILLE, TN - Two mid-state residents are charged with TennCare fraud in Williamson County, and both cases involve prescription drugs. The Office of Inspector General today announced the arrests of Barbara A. Knupp, 29, and Dakota Lee Osan, 20, both of College Grove.
May 5, 2014; Tennessee Department of Finance & Administration: Mississippi Woman Charged With TennCare Fraud
NASHVILLE, TN - A Mississippi woman is charged with TennCare fraud and theft of property after obtaining TennCare healthcare insurance benefits she didn't qualify for. The Office of Inspector General today announced the arrest of Kim Jackson, 38, of Olive Branch, Mississippi. The arrest brings to 2,100 the number of people arrested for TennCare since the OIG began investigating and pursuing this criminal activity. There have been 6,648 criminal charges filed.
May 5, 2014; New York Attorney General: A.G. Schneiderman Announces Prison Term For Rogue Pharmacy Owner In $16 Million Medicaid Theft
NEW YORK -- Attorney General Eric T. Schneiderman announced that Raheel Pervez was sentenced to a 1-to-3-year prison term today for his part in a multi-year scheme that drained in excess of $16 million from the state Medicaid program. Pervez, 41, who pleaded guilty to felony Enterprise Corruption, is one of six individuals arrested by the Attorney General's Medicaid Fraud Control Unit in a scheme that involved a web of more than a dozen pharmacies. They defrauded the Medicaid program by targeting vulnerable HIV patients and put their lives in jeopardy by paying them not to fill their HIV prescriptions and then billing Medicaid for those unfilled prescriptions. Three of the pharmacies, two of which operated as the scam's central hubs, were previously ordered to pay $16.7 million in restitution to Medicaid. In addition to incarceration, Pervez has agreed to pay $500,000 in civil forfeiture.
May 2, 2014; Tennessee Department of Finance & Administration: Sullivan Co. Woman Charged With TennCare Fraud
NASHVILLE, TN - A Sullivan County woman is charged with TennCare fraud for using the state Medicaid program to obtain prescription drugs, which she later apparently sold. The Office of Inspector General today announced the arrest of Randee Marie Moore, 27, of Bristol, after a joint investigation with the Bristol Police Department.
May 1, 2014; Florida Attorney General: Attorney General Pam Bondi's Medicaid Fraud Control Unit Performs Licensed Healthcare Facility Checks in Flooded Areas
TALLAHASSEE, Fla.-Attorney General Pam Bondi's Medicaid Fraud Control Unit today performed checks of licensed healthcare facilities in areas affected by the flooding in Florida's panhandle. The Medicaid Fraud Control Unit is a partner agency pursuant to the existing State Comprehensive Emergency Management Plan. Acting on a request from the Agency for Health Care Administration, staff from the MFCU today checked facilities to identify any public health and medical needs, and if required, to coordinate medical stabilization in affected counties, and to assist with the sheltering of people with medical needs, among other things.
May 1, 2014; Tennessee Department of Finance & Administration: Dyer Co. Man Charged With TennCare Doctor Shopping
NASHVILLE, TN - A Dyer County man is charged with TennCare fraud involving doctor shopping, or using TennCare to go to multiple doctors to obtain controlled substances. The Office of Inspector General announced the arrest of Donald K. Buckner, Sr., 54, of Dyersburg. He is charged with three counts of fraudulently obtaining controlled substances through TennCare by doctor shopping for the painkillers Oxycodone, Hydrocodone, Meperidine and Morphine. He used TennCare benefits to pay for the clinical visits.
April 30, 2014; Washington Attorney General: Attorney General's Office recovers $259,649 from Tacoma-based firm in Medicaid fraud investigation
OLYMPIA-In response to allegations that it knowingly overbilled the state over an eight-year period, a Tacoma-based physician group will pay $259,649 to the state's Medicaid program. Sound Inpatient Physicians employs hospitalists and other physicians who provide care to patients at hospitals and other facilities. Hospitalists are physicians who provide in-patient care to hospital and other facility patients. Sound contracts with hospitals and other facilities to provide these services.
April 30, 2014; Tennessee Department of Finance & Administration: Blount Co. Woman Charged With TennCare Fraud
NASHVILLE, TN - A Blount County woman is charged with TennCare fraud in nearby Knox County, after obtaining healthcare insurance benefits through TennCare, even though she was not eligible for the program. The Office of Inspector General today announced the arrest of 27-year old Amanda Carolyn Duncan, who also used the name Amanda Carolyn Goodson, of Louisville, Tennessee.
April 29, 2014; Tennessee Department of Finance & Administration: Sumner Co. Woman Charged With 17 Counts Of TennCare Drug Fraud Wanted For Seven Months
NASHVILLE, TN - A Sumner County woman is charged with TennCare fraud involving prescription drugs, after eluding authorities for seven months. The Office of Inspector General today announced the arrest of 27-year old Laci M. Grogan, who also used the name Laci M. Griffin, of Hendersonville. The Sumner County Sheriff's Office assisted with the arrest. Grogan is charged with 17 counts of TennCare fraud and seven counts of obtaining a controlled substance by fraud.
April 25, 2014; New York Attorney General: A.G. Schneiderman Announces Charges Filed Against 17 Nursing Home Employees For Neglecting Disabled Resident
BUFFALO - Attorney General Eric T. Schneiderman today announced that charges were filed against 17 employees of Highpointe on Michigan Health Care Facility in Buffalo, following an investigation into their treatment of a nursing home resident. The investigation, which relied on a hidden camera placed in the patient's room, revealed a disturbing pattern of neglect. The eight nurses and nine nursing assistants are being charged with a variety of felony and misdemeanor counts in Buffalo City Court.
April 25, 2014; Tennessee Department of Finance & Administration: Sullivan Co. Woman Charged 2nd Time With TennCare Fraud
NASHVILLE, TN - A Sullivan County woman is charged with TennCare fraud for the second time. The Office of Inspector General, with assistance from the Washington County Sheriff's Office, today announced the arrest of Kristy Dawn Kindle, 37, of Kingsport. She is charged in an indictment with claiming to be pregnant in order to obtain TennCare benefits. Otherwise, she would have been ruled ineligible for the state's Medicaid program.
April 25, 2014; Tennessee Department of Finance & Administration: Jefferson Co. Woman Charged With TennCare Doctor Shopping
NASHVILLE, TN - A Jefferson County woman is charged with TennCare fraud involving doctor shopping, or using the state's Medicaid healthcare insurance program to pay for multiple physician visits in order to obtain controlled substances. The Office of Inspector General, with assistance from the Jefferson County Sheriff's Office, today announced the arrest of Shirley J. Whitehead, 46, of Jefferson City.
April 25, 2014; New Jersey Department of Law and Public Safety: Monmouth County Woman Charged with Attempting to Steal More Than $500,000 by Submitting Over 100 Fraudulent Invoices
TRENTON - Acting Attorney General John J. Hoffman announced that a Monmouth County woman has been indicted for allegedly attempting to steal more than $500,000 by submitting over 100 fraudulent invoices to her insurance company for reimbursement for medical services that she never received.
April 24, 2014; Florida Attorney General: Attorney General Pam Bondi's Medicaid Fraud Control Unit and the South Miami Police Department Arrest a Miami Woman for Battery on a Disabled Adult
TALLAHASSEE, FL - Attorney General Pam Bondi's Medicaid Fraud Control Unit and the South Miami Police Department arrested Miami resident Christina Monroe for battery on a disabled adult. Monroe was working as a behavioral health technician at MACtown, Inc., a center for developmentally disabled adults located in Miami. According to the investigation by the Medicaid Fraud Control Unit's Patient Abuse, Neglect and Exploitation team Monroe's co-workers witnessed her repeatedly punching a disabled adult in the face. The victim received a laceration to the right eye, requiring three stitches.
April 24, 2014; Tennessee Department of Finance & Administration: Jefferson Co. Woman Charged With TennCare, Food Stamp Fraud
NASHVILLE, TN - A Jefferson County woman is charged with TennCare fraud and food stamp fraud in connection with falsely reporting her assets in order to qualify for both programs. The Office of Inspector General, with the assistance of the Jefferson County Sheriff's Office, today announced the arrest of Shonda Griffin, 33, of White Pine. She is charged with TennCare fraud, food stamp fraud, and two counts of theft of services.
April 24, 2014; Tennessee Department of Finance & Administration: Madison Co. Man Charged With TennCare Fraud
NASHVILLE, TN - After being on the run for nearly a year, a Madison County man faces TennCare fraud charges out of Crockett County. The Office of Inspector General, with assistance from Jackson and Crockett County officers, today announced the arrest of Dall T. Coleman, 47, of Jackson.
April 22, 2014; Wisconsin Attorney General: Milwaukee Man Sentenced For Medicaid Fraud
MADISON -Attorney General J.B. Van Hollen announced today that Tyvex Benford has been sentenced in Milwaukee County on two convictions for Medicaid fraud. Milwaukee County Circuit Court Judge William Brash imposed and stayed sentences of imprisonment for three years, to be served concurrently to each other and consecutive to any other sentences, comprising 18 months initial confinement and 18 months extended supervision. He then placed Benford on probation for two years, with conditions of six months in jail, alcohol or other drug abuse assessment, anger management treatment, participation in a criminal thinking program, preclusion as a payee for any government public assistance program, and payment of $3,546 restitution.
April 22, 2014; Tennessee Department of Finance & Administration: Georgia Woman Charged With TennCare Fraud
NASHVILLE, TN- A Georgia woman is in custody on TennCare fraud charges, in an indictment accusing her of claiming to live in Tennessee in order to get healthcare insurance benefits through TennCare, the state's Medicaid program. The Office of Inspector General today announced the arrest of 41-year old Tammie Renee Taylor, also known as Tammie Renee Beck and Tammie R. Anthony, of Fort Oglethorpe, Georgia. That's about nine miles from the Tennessee border at Chattanooga.
April 21, 2014; Tennessee Department of Finance & Administration: Warren Co. Woman Charged 2nd Time With TennCare Doctor Shopping
NASHVILLE, TN - A Warren County woman is charged for a second time with doctor shopping for controlled substances, using TennCare benefits as payment. The Office of Inspector General today announced the arrest of 28-year old Amber L. Briggs, of McMinnville. She is charged in a Unicoi County indictment with fraudulently obtaining a controlled substance by doctor shopping for prescription drugs, using TennCare to access healthcare benefits.
April 21, 2014; Maryland Attorney General: AG Gansler: Caregiver Pleads Guilty to Neglect of a Vulnerable Adult
Baltimore, MD - Attorney General Douglas F. Gansler announced today that Duriel Maurice Briggs, 34, of Woodlawn, pleaded guilty to one count of Neglect of a Vulnerable Adult in the Second Degree for an incident that occurred last summer in Woodlawn. At the time, Mr. Briggs was a caregiver employed by Creative Options Inc., an organization that provides supportive services to Maryland citizens with disabilities. Briggs was responsible for the care and supervision of a 23-year-old man with developmental disabilities who needed 24-hour supervision and resided in a group home in Randallstown operated by Creative Options.
April 17, 2014; Florida Attorney General: Attorney General's Office Announces Arrest of Hillsborough County Woman for Medicaid Fraud
TALLAHASSEE, Fla.-Attorney General Pam Bondi's Medicaid Fraud Control Unit and the Hillsborough County Sheriff's Office today arrested Hillsborough County resident Esther Stirewalt for Medicaid fraud. According to the MFCU's investigation, Stirewalt allegedly received more than $8,000 for personal care services provided to a disabled adult, which were actually never provided. Stirewalt was employed by Tampa Bay Patient Services.
April 17, 2014; Tennessee Department of Finance & Administration: Coffee Co. Man Charged With TennCare Fraud In Multi-Agency Undercover Investigation
NASHVILLE, TN - A Coffee County man is charged with TennCare fraud after an undercover operation that led to indictments of 60 people. So far, a total of 40 have been arrested. The Office of Inspector General today announced the arrest in the investigation that involved officers from Manchester Police and the Coffee County Sheriff's Office. Most of the charges involve prescription drug fraud. James Edwards, 47, of Hillsboro, Tennessee is
April 16, 2014; Alaska Attorney General: Anchorage Physician Arrested for Fraudulently Billing Medicaid and Tampering with Physical Evidence
The Alaska Department of Law, Medicaid Fraud Control Unit announced today the arrest of an Anchorage area physician for fraudulently billing Medicaid for hundreds of thousands of dollars and for tampering with physical evidence in an ongoing investigation. Dr. Shubhranjan Ghosh, 39, of Anchorage, Alaska and the founder of Ghosh Psychiatric Services, was arrested yesterday evening on a criminal complaint alleging that he committed medical assistance fraud, scheme to defraud and evidence tampering.
April 16, 2014; Louisiana Attorney General: 20 Arrested In Medicaid Fraud Roundup
The Louisiana Attorney General's Medicaid Fraud Control Unit (MFCU) this week arrested 20 personal care attendants as part of a crackdown on provider fraud in the New Orleans area. MFCU agents initiated an investigation after receiving a citizen tip reporting potential personal care service fraud. Investigators learned that the personal care attendant being accused of fraudulent activity was servicing a Medicaid recipient living at a senior residential facility in New Orleans. Many other elderly residents living at the same housing complex are eligible for personal care services rendered through private provider agencies that bill the Louisiana Medicaid Program.
April 16, 2014; Arkansas Attorney General: Pulaski County Women Arrested For Medicaid Fraud
LITTLE ROCK - Attorney General Dustin McDaniel announced today that two Pulaski County women have been arrested for allegedly bilking the Arkansas Medicaid program out of more than $41,000. Darann Bright Harrison, 57, and her daughter, Tamecia Dion Bright, 34, both of Little Rock, were arrested last week following an investigation by the Attorney General's Medicaid Fraud Control Unit. Both are charged with Medicaid Fraud, a Class B felony. Both were released from the Pulaski County Detention Center after each posted a $2,500 bond.
April 11, 2014; South Carolina Attorney General: Gable Man Convicted on Ten Counts of Medicaid Provider Fraud
Willie Lee Bethune of Gable, South Carolina was convicted on ten (10) counts of Medicaid fraud in Richland General Sessions Court on April 10, 2014. The fraud occurred in 2010, when Bethune worked for Youth Options, which had an agreement to provide counseling services to students in Clarendon School District One. No service was provided.
April 11, 2014; Tennessee Department of Finance & Administration: Four Charged With TennCare Fraud In DeKalb Co.
NASHVILLE, TN - Four people in DeKalb County are charged with TennCare fraud, after an undercover operation involving prescription drugs that were paid for by the state's Medicaid program. The Office of Inspector General and the DeKalb County Sheriff's Office today announced the arrests.
April 9, 2014; Tennessee Department of Finance & Administration: Two Charged With TennCare Fraud In Union County
NASHVILLE, TN - Two people are charged with TennCare fraud for selling prescription drugs that were purchased using TennCare healthcare benefits. The Office of Inspector General today announced the arrest of Robin D. Wilkerson, 45, of Maynardville and Richard Rupe, 58, of Corryton, after a joint investigation with the 8th Judicial Drug Task Force and the Union County Sheriff's Department.
April 11, 2014; Attorney General of Massachusetts: Worcester Woman and Her Son Arraigned in Alleged Scheme to Steal $96,000 From MassHealth
BOSTON - A Worcester woman and her son have been arraigned in connection with multiple schemes using family names to falsely bill the state's Medicaid program (MassHealth) for more than $96,000 of Personal Care Attendant (PCA) services that were never provided, allegedly using the proceeds for their own benefit, Attorney General Martha Coakley announced today.
April 8, 2014; Florida Attorney General: Miami-Dade Woman Arrested for Billing Medicaid Program $350,000 for Bogus Vascular Ultrasounds
TALLAHASSEE, Fla.-Following an investigation by Attorney General Pam Bondi's Medicaid Fraud Control Unit, Miami-Dade County resident Lourdes Haber has been arrested for billing Florida's Medicaid program for $350,000 worth of bogus vascular ultrasounds and related services. Haber owns Caribe Medical Center of Homestead, Inc., and according to the MFCU's investigation, she billed the Medicaid program for vascular ultrasounds that were neither prescribed nor performed.
April 8, 2014; Tennessee Department of Finance & Administration: Wayne Co. Woman Charged With TennCare Drug Fraud
NASHVILLE, TN -- A Wayne County woman is charged with TennCare fraud related to selling prescription drugs paid for by the Medicaid healthcare insurance program. The Office of Inspector General today announced the arrest of Tracy Griggs, 48, of Waynesboro, after a joint investigation with the Wayne County Sheriff's Office.
April 7, 2014; Tennessee Department of Finance & Administration: Knox Co. Woman Charged With TennCare Fraud
NASHVILLE, TN -- A Knox County woman is charged with TennCare fraud for apparently reporting a false income in order to obtain TennCare benefits. The Office of Inspector General, with the assistance of the Knox County Sheriff's Office, today announced the arrest of Lisa A. Adams, also known as Lisa Ann Stryder, 35, of Knoxville
April 7, 2014; Tennessee Department of Finance & Administration: Warren Co. Woman Charged With TennCare Doctor Shopping
NASHVILLE, TN - A Warren County woman is charged with TennCare fraud in Rutherford County in a case involving prescription drugs. The Office of Inspector General today announced the arrest of Amber L. Briggs, 28, of McMinnville. She is charged with two counts of fraudulently using TennCare to obtain controlled substances by doctor shopping. An indictment accuses her of going to multiple physicians within a short period of time, receiving prescriptions for the same or similar controlled substances, with the clinical visits or the prescriptions being paid for with TennCare benefits. Briggs turned herself in to the Rutherford County Sheriff's Office.
April 4, 2014; Tennessee Department of Finance & Administration: Sullivan Co. Man Arrested After Eluding TennCare Fraud Charges
NASHVILLE, TN - A Sullivan County is in custody almost a year after he was charged with TennCare fraud. The Office of Inspector General (OIG), with assistance from Kingsport Police and the Sullivan County Sheriff's Department, today announced the arrest of Phillip Serpas, 31, of Kingsport. A four-count indictment returned by a grand jury in June of last year - 11 months ago - charges him with presenting an altered diagnostic imaging report and patient profile for the purposes of fraudulently obtaining prescriptions from a doctor for painkiller Oxycodone and the anti-anxiety medication Alprazolam. Serpas used TennCare benefits to pay for the fraudulent Oxycodone prescriptions.
April 3, 2014; Idaho Attorney General: Draine Sentenced for Abuse, Neglect and Medicaid Fraud
Boise - Paul J. Draine, of Garden City, was sentenced today for neglecting his mother and submitting claims to Medicaid for fraudulent services, Attorney General Lawrence Wasden said. Fourth District Judge Lynn Norton sentenced Draine to one year fixed in prison and four years indeterminate. The court suspended the prison sentence and ordered Draine to enter the Rising Sun Sober Living facility. He was placed on supervised probation for five years and ordered to pay $23,408 in restitution to the Department of Health and Welfare, Division of Medicaid, Medicare and a private insurance company.
April 2, 2014; Indiana Attorney General: Anderson Dental Center Owner, Employees, Dentists Criminally Charged
ANDERSON, Ind. - Criminal charges including Medicaid fraud and corrupt business influence were filed Tuesday against the unlicensed owner of Anderson Dental Center Inc., three dentists who practiced at the center and four of its employees, Indiana Attorney General Greg Zoeller announced today. The criminal charges filed in Madison County Circuit Court 6 allege that Anderson Dental Center owner Sally Metzner and her co-defendants engaged in a scheme to submit false and inflated claims for payment of dental services to the Indiana Medicaid program, sometimes using forged documents, in order to receive more Medicaid reimbursement than they were due.
April 2, 2014; Tennessee Department of Finance & Administration: Davidson Co. Woman Charged 2nd Time With TennCare Doctor Shopping
NASHVILLE, TN - A Davidson County woman is charged in Franklin County with TennCare fraud involving doctor shopping, or using TennCare to go to multiple doctors in a short time frame to obtain controlled substances. The Office of Inspector General today announced the arrest of Sherry Ryan, 32, of Nashville. A Franklin County Grand Jury charged her with three counts of fraudulently obtaining TennCare controlled substance benefits to which she was not entitled by doctor shopping. Ryan is accused of obtaining the painkiller Hydrocodone in physician office visits that were paid for by TennCare.
April 1, 2014; New York Attorney General: A.G. Schneiderman Announces Guilty Plea Of Former Nursing Home Nurse For Neglecting Elderly Resident
POUGHKEEPSIE -- Attorney General Eric T. Schneiderman announced today that David Klaproth, a licensed practical nurse formerly employed by the Wingate at Dutchess nursing home in Fishkill, N.Y., pleaded guilty to neglecting a blind 73-year-old resident of the home. Appearing before Fishkill Town Court Justice Robert Rahemba, Klaproth, 47, admitted to a misdemeanor charge, Wilful Violation of the Health Laws, after acknowledging that he failed to administer a prescribed medication to the elderly resident, who also suffers from Alzheimer's disease.
April 1, 2014; Florida Attorney General: Home Health Agency Administrator and Aide Arrested for Defrauding Medicaid Out of More Than $18,000
Tallahassee, Fla.- Attorney General Pam Bondi announced that two Broward county residents are in custody after allegedly defrauding the Florida Medicaid program out of more than $18,000. The Attorney General's Medicaid Fraud Control Unit arrested Julia Privis and Alla Privis on felony warrants.

March 2014

March 31, 2014; Washington Attorney General: AGO files Medicaid Fraud charges against Federal Way man
OLYMPIA - The Attorney General's Office today filed charges in King County Superior Court against a Federal Way man the state alleges fraudulently obtained more than $15,000 from the state and federal government in three different schemes involving Medicaid, food stamps and social security.
March 31, 2014; Florida Attorney General: Attorney General Bondi Announces Arrest of Two Duval County Women for Neglect of a Disabled Adult
Tallahassee, Fla.-Following an investigation led by Attorney General Pam Bondi's Medicaid Fraud Control Unit, the MFCU and the Jacksonville Sheriff's Office have arrested Leathia Bonner, 47, and Linda Ginn, 59, on charges of Neglect of a Disabled Adult, third degree felonies.
March 31, 2014; Massachusetts Attorney General: Former Personal Care Attendant Pleads Guilty to Defrauding $63,000 From State Medicaid System
Northampton - A former Personal Care Attendant (PCA) from Agawam has pleaded guilty to stealing close to $63,000 from the state's Medicaid program (MassHealth) for services that were not provided, Attorney General Martha Coakley announced today. According to authorities, Lynch submitted false timesheets to MassHealth indicating care for a patient while he was working as a bus driver at the Lower Pioneer Valley Educational Collaborative.
March 27, 2014; Florida Attorney General: Attorney General Bondi's Office Announces the Arrest of a Tallahassee Woman for More Than $25,000 in Medicaid Fraud
Tallahassee, Fla.-Attorney General Pam Bondi announced today that following an investigation by her Medicaid Fraud Control Unit, Tallahassee resident Melinda Warren turned herself in to the Leon County Jail, for more than $25,000 in Medicaid fraud. The Medicaid Fraud Control Unit began its investigation into Warren's billing practices after receiving a referral from the Agency for Persons with Disabilities.
March 27, 2014; New York Attorney General: A.G. Schneiderman Announces Sentencing Of Business Manager For Theft Of Nursing Home Residents' Funds
Massena - Attorney General Eric T. Schneiderman today announced the sentencing of Wendy Vice, a former nursing home business manager who admitted to stealing $18,000 in resident funds. Vice, of Massena, was sentenced to three years' probation, which will include counseling for gambling problems, Wednesday afternoon in Massena Village Court by the Honorable Gerald P. Sharlow. On September 25, 2013, the defendant pleaded guilty to petit larceny for diverting funds to her own use in 2011 and 2012.
March 26, 2014; Vermont Attorney General: Four Individuals Charged With Medicaid Fraud Related To In Home/Community-Based And Personal Care Services That Were Not Provided
Four individuals enrolled as either caregivers or employers-of-record in Vermont's Medicaid-funded Home and Community Based (HCBS) or Personal Care programs were separately arraigned yesterday in Vermont Superior Court for Windsor County on felony counts of Medicaid Fraud for allegedly billing for care to children and vulnerable adults that was not provided. Collectively, these individuals are alleged to have submitted thirty-four fraudulent timesheets for almost two thousand hours of care that was not rendered, resulting in overpayments by the Vermont Medicaid program of approximately $18,000.
March 26, 2014; Vermont Attorney General: Brandon Man Convicted For Falsely Obtaining Monies From The Vermont Medicaid Program
Richard Weldon of Brandon, Vermont, was convicted on March 25, 2014, in Vermont Superior Court, Windsor Criminal Division, of five misdemeanor counts of False Pretenses. The convictions stemmed from Mr. Weldon's submission of falsified timesheets in order to obtain payment for services that were not provided while he was an employer-of-record for a home-based health care worker under the Developmental Disability Services program, a Vermont Medicaid program.
March 24, 2014; Kentucky Attorney General: Attorney General Conway Announces Indictment & Arrest of Former Director of Caretaker Service
Attorney General Jack Conway and his Medicaid Fraud and Abuse Control Unit today announced that a former director of a Kentucky caretaker service has been indicted on charges involving forgery and fraud. On March 4, a Fayette County grand jury charged Cheron L. Miller, 35, with four counts of second-degree forgery and one count of defrauding the Kentucky Medicaid program, which are class D felonies. Miller was arrested today by an investigator with Attorney General Conway's Medicaid Fraud and Abuse Control Unit and the Lexington Police Dept.
March 24, 2014; Delaware Attorney General: Nurse Arrested and Charged With Using Forgery, Fraud to Obtain Prescription Drugs
Dover - Attorney General Beau Biden announced that a former nurse at the Delaware Hospital for the Chronically Ill has been arrested and charged with numerous crimes related to her alleged use of fraud and forgery to obtain prescription drugs that were intended for patients at the facility. Danielle M. Tharp-Strouse, 31, of the 6100 block of Mud Mill Road in Camden, was arrested on March 21, 2014 by Biden's Medicaid Fraud Control Unit. She has been charged with three felony counts of Obtaining a Controlled Substance by Misrepresentation or Fraud or Forgery, seven counts of Second-Degree Forgery and one count of Falsifying a Business Record.
March 21, 2014; Georgia Attorney General: DeKalb Physician Sentenced to Prison for Medicaid Fraud
On March 21, 2014, DeKalb Superior Court Judge C. J. Becker sentenced Tyrone Cecil Malloy, M.D., to four years in prison and six years probation on two counts of Medicaid Fraud, O.C.G.A. § 49-4-146.1(b)(2). Malloy was found guilty by a jury on both counts of the indictment on March 10, 2014, following a two-week trial.
March 20, 2014; Massachusetts Attorney General: Worcester Woman Charged for Alleged Scheme with Son to Steal $96,000 From MassHealth
Boston - A Worcester woman and her son have been charged in multiple schemes using family names to falsely bill the state's Medicaid program (MassHealth) for more than $96,000 of Personal Care Attendant (PCA) services that were never provided, allegedly using the proceeds for their own benefit, Attorney General Martha Coakley announced today.
March 20, 2014; Tennessee Department of Finance & Administration: Sullivan Co. Woman Charged With TennCare Drug Fraud
Nashville, TN - A Sullivan County woman is accused of TennCare fraud for attempting to use the program to pay for a forged prescription. The Office of Inspector General today announced the arrest of 22-year old Brittany Olmos, of Kingsport. She was indicted on charges of TennCare fraud and attempting to obtain a controlled substance by fraud. The charges against her say she presented a forged prescription at a pharmacy, and tried to use TennCare benefits to pay for the forgery.
March 20, 2014; Tennessee Department of Finance & Administration: Lauderdale County Woman Charged With TennCare Doctor Shopping
Nashville, TN - A Lauderdale County woman is charged in nearby Tipton County with TennCare fraud involving doctor shopping, or using TennCare to go to multiple doctors to obtain controlled substances. The Office of Inspector General, with the assistance of the Tipton County Sheriff's Office, today announced the arrest of Brenda Allen, 48, of Ripley. She has been charged with three counts of doctor shopping for the pain killer Oxycodone, with the doctor's office visits paid for by TennCare.
March 20, 2014; Tennessee Department of Finance & Administration: Four Charged With TennCare Fraud In Hamblen Co. Round-Up
Nashville, TN - Four people are charged with TennCare fraud after a round-up of 60 people who face 106 charges involving prescription drugs. The arrests are the results of an undercover investigation involving the Hamblen County Sheriff's Office and the Office of Inspector General.
March 17, 2014; New York Attorney General: A.G. Schneiderman Announces Guilty Plea By Former Assistant Manager Of Disability Services Center For Stealing Money From Disabled Residents
Schoharie - Attorney General Eric T. Schneiderman announced that today, Samantha Cross, 31, former assistant manager at Schoharie ARC - a center for individuals with disabilities - pled guilty to stealing money from disabled residents. Cross appeared before Judge Kennneth Knutsen, Schoharie Town Court Justice, and pled guilty to a second degree misdemeanor charge of falsifying business records after acknowledging stealing a total of $1,503. As part of the plea agreement, Ms. Cross will pay restitution for the funds that were stolen.
March 14, 2014; Massachusetts Attorney General: Milton Physician Pleads Guilty to Illegally Prescribing Drug Used to Treat Opiate Addiction
Boston - The former head of a substance abuse clinic in Brighton pleaded guilty to charges that he illegally prescribed a drug used to treat opiate addiction and collected illegal fees from patients, Attorney General Martha Coakley announced today. Dr. Richard Ng, 54, of Milton, pleaded guilty today in Suffolk Superior Court on charges of Illegal Prescribing (11 counts), Medicaid False Claims (9 counts), and Medicaid Excess Charges (7 counts). After the pleas were entered, Superior Court Judge Frances McIntyre sentenced Ng to two and a half years in the House of Correction, suspended for a probationary period of five years, with six months of home confinement on GPS monitoring as a special condition.
March 14, 2014; Tennessee Department of Finance & Administration: Four Charged With TennCare Fraud In Wilson Co. Round-Up Of 83
Nashville, TN - Four people in Wilson County are charged with TennCare drug fraud after a round-up charging 83 people with prescription drug-related crimes. The arrests came after an undercover investigation involving the Wilson County Sheriff's Office and the Office of Inspector.
March 14, 2014; Tennessee Department of Finance & Administration: Former Robertson Co. Woman Arrested In North Carolina For TennCare Fraud
Nashville, TN - After being on the run for four months, a Robertson County woman has been arrested in Greenville, North Carolina, and returned to Tennessee on TennCare fraud charges. The Office of Inspector General with the assistance of the 19th Judicial Drug Task Force and the Robertson County Sheriff's Office, today announced the arrest of Michelle Dawn O'Quinn, 32, of Greenville, North Carolina, where she was residing.
March 17, 2014; Office of Inspector General; Texas Health and Human Services Commission: OIG Reaches $3.75 Million Settlement with Carousel
AUSTIN - Carousel Pediatrics has agreed to repay the state $3.75 million after an investigation by the Health and Human Services Commission Office of Inspector General (OIG) found a pattern of billing errors. Carousel Pediatrics currently provides primary care for more than 25,000 Texas children. OIG's medical reviews demonstrated the quality of care Carousel provided was often similar to other Medicaid providers, but its billing practices meant that it billed the state too much for those services.
March 13, 2014; Tennessee Department of Finance & Administration: Two Davidson Co. Residents Charged With TennCare Fraud
NASHVILLE, TN - Two Davidson County residents are charged with TennCare fraud in unrelated cases involving prescription drugs. The Office of Inspector General today announced charges filed against Edward Dwight Condra, 40, and Tiffany N. Smith, 28, both of Nashville. Metro Nashville Police assisted in the cases.
March 12, 2014; Tennessee Department of Finance & administration: Tipton Co. Woman Charged With TennCare "Doctor Shopping"
NASHVILLE, TN - A Tipton County woman is charged with TennCare fraud involving doctor shopping, or using the state's Medicaid program to go to multiple doctors to obtain controlled substances. The Office of Inspector General today announced the arrest of Misty Benard Jones, 34, of Covington. She is charged with two counts of fraudulently using TennCare to obtain controlled substances by doctor shopping, using TennCare as payment. Jones used TennCare benefits to pay for the controlled substance and the clinical visit.
March 11, 2014; New York Attorney General: A.G. Schneiderman Announces Arrests of Pharmacy Owners and Pharmacist for Operating Illegal Prescription Buyback Operation
NEW YORK -- Attorney General Eric T. Schneiderman today announced the arrest of three men for defrauding government-funded health care programs by buying back prescriptions and billing Medicaid as if the medication had been dispensed. The two owners of 184th Street Pharmacy in the Bronx, along with the supervising pharmacist, targeted financially vulnerable patients, putting their health at risk by paying them to forgo necessary anti-retroviral HIV medications.
March 11, 2014; New York Attorney General: A.G. Schneiderman Announces Sentencing Of Dentist Who Lied About Past Conviction
ALBANY - Attorney General Eric T. Schneiderman today announced the sentencing of David W. Holloway, D.D.S., on a felony conviction for lying about a past conviction while seeking a dental license in New York State. Holloway was convicted of Offering a False Instrument for Filing in the First Degree based on documents filed with New York State.
March 11, 2014; Tennessee Department of Finance & Administration: Roane County Woman Charged With TennCare Fraud
NASHVILLE, TN - A Roane County woman is charged with TennCare fraud for falsely reporting her income in order to be eligible for healthcare insurance benefits through the state's Medicaid program. The Office of Inspector General today announced the indictment and arrest of Kesha L. Perkins, 34, of Rockwood. The Roane County Sheriff's Office assisted with the arrest.
March 10, 2014; Tennessee Department of Finance & Administration: Franklin County Woman Charged With TennCare Drug Fraud
NASHVILLE, TN - A Franklin County woman is charged with TennCare fraud in connection with selling prescription drugs paid for by the state's Medicaid program. The Office of Inspector General today announced the arrest of Penny D. Philpot, 37, of Decherd, after a joint investigation with the Franklin County Sheriff's Office.
March 7, 2014; Tennessee Department of Finance & Administration: Tipton County Man Charged With TennCare Drug Fraud
NASHVILLE, TN - A Tipton County man is charged with TennCare fraud for selling prescription drugs which were paid for by the state's Medicaid program. The Office of Inspector General charged Johnny Eugene Story, 37, of Brighton. He was served with the indictment at the Tipton County Jail, where he is serving time for unrelated charges.
March 6, 2014; Tennessee Department of Finance & Administration: Henry County Couple Charged With TennCare Drug Fraud
NASHVILLE, TN - A Henry County couple is charged with using the TennCare program to pay for a fraudulent prescription. The Office of Inspector General today announced the arrest of Michael Lonnie Burton, 57, and Phyllis Jane Burton, 41, both of Paris. The arrest is the result of a joint effort with the Paris Police Department.
March 6, 2014; Tennessee Department of Finance & Administration: Mississippi Woman Pleads Guilty To TennCare Fraud, Must Repay State $14,400
NASHVILLE, TN - A Mississippi woman charged with TennCare fraud is under court order to repay the state for healthcare services she received while fraudulently enrolled in the state's Medicaid program. The Office of Inspector General today announced the court judgment against 28-year old Angela Tillery, of Horn Lake, Mississippi, after she pleaded guilty to three counts of TennCare fraud and theft of property. A Shelby County Criminal Court ordered Tillery to pay restitution in the amount of $14,400, serve 120 days in jail, and be placed on six years supervised probation.
March 6, 2014; Maryland Attorney General: AG Gansler: Montgomery Co. Woman Pleads Guilty to Medicaid Fraud
Baltimore, MD (March 6, 2014) - Attorney General Douglas F. Gansler announced today that Deanne Grant, 47, of Montgomery Village, pleaded guilty to one count of Felony Medicaid Fraud for submitting multiple false claims over a period of more than two-and-a-half years. Baltimore City Circuit Court Judge Marcus Z. Shar sentenced Grant to 364 days probation, 80 hours of community service and ordered restitution of $3,385.14 to the Maryland Medicaid program, plus $2,500 to be paid to the Office of the Attorney General. The payments are in addition to a civil settlement reached last summer.
March 3, 2014; Washington Attorney General: AGO files Medicaid Fraud charges in Thurston County
Olympia - The Attorney General's Office on Friday filed charges in Thurston County Superior Court against a woman the state alleges billed Washington Medicaid for more than $87,000 in healthcare provider services while living in Nevada. Prosecutors with the Attorney General's Office Medicaid Fraud Control Unit (MFCU) charged Peggy Ruth Kerr with one count of First Degree Theft and one count of Medicaid False Statement.
March 3, 2014; Georgia Attorney General: Clayton County Woman Sentenced to Ten Years in Prison for Medicaid Fraud
On Friday, February 28, 2014, a Clayton County jury convicted Catherine Pinkard, of Clayton County, Ga., of one felony count of Medicaid Fraud and one felony count of Theft by Taking for fraudulently billing Georgia Medicaid. Clayton County Chief Superior Court Judge Deborah C. Benefield sentenced Pinkard to ten years in prison.
February 28, 2014; Missouri Attorney General: Attorney General Koster Files Criminal Charges In Medicaid Fraud Case As Webster County Woman Faces 8 Felony Counts
Jefferson City, Mo. - Attorney General Chris Koster said today his office has charged a licensed professional counselor in the Springfield area with eight felony counts of Medicaid fraud. Koster charged Sherri Grove for billing Medicaid for family-therapy services that she did not provide. The Attorney General's Medicaid Fraud Control Unit is assisting Webster County Prosecuting Attorney Danette L. Padgett in the prosecution.
February 28, 2014; Louisiana Attorney General: Zachary woman busted in Medicaid fraud scheme
A Zachary woman has been arrested for defrauding the state's Medicaid program out of thousands of dollars and laundering more than $100,000 through her Baton Rouge based personal care agency, announced Louisiana Attorney General Buddy Caldwell.
February 28, 2014; Tennessee Department of Finance & Administration: Cocke Co. Woman Charged A 3rd Time With Doctor Shopping
NASHVILLE, TN - A Cocke County woman is charged for a third time with doctor shopping, or going to multiple doctors to obtain the same or similar controlled substances and using TennCare, the state's Medicaid program, as payment. The Office of Inspector General today announced the arrest of 20-year old Diamond Pearl Ahrens, of Newport. A Cocke County indictment accuses her of three counts of fraudulently obtaining a controlled substance by doctor shopping, with TennCare paying for the physician visits. The Cocke County Sheriff's Office assisted in Ahrens's arrest.
February 28, 2014; Florida Attorney General: Attorney General Pam Bondi's Office Announces Arrest of Hillsborough County Man for Medicaid Fraud
Tallahassee, Fla.-John Johnson was arrested by the Hillsborough County Sheriff's Office on a felony warrant from Attorney General Pam Bondi's Medicaid Fraud Control Unit. According to an investigation by the Medicaid Fraud Control Unit, Johnson allegedly billed the Medicaid program for more than $3,000 dollars' worth of services never provided to a disabled patient in his care. Johnson was employed by Assure Solutions in Tampa, Fla.

February 2014

February 27, 2014; Tennessee Department of Finance & Administration: Davidson Co. Woman Charged With TennCare Drug Fraud
Nashville, TN - A Davidson County woman is charged with TennCare fraud in connection with using the state's healthcare insurance program to pay for fraudulent prescriptions. The Office of Inspector General, with assistance from Metro Nashville Police, today announced the arrest of Sandra Larraine Marchant-Macias, also known as Sandra L. Agee, 23, of Nashville.
February 26, 2014; Mississippi Attorney General: Registered Nurse Arrested for Depraved Heart Murder of Patient
A registered nurse in Hattiesburg is facing charges of depraved heart murder, announced Attorney General Jim Hood today. April Renae Grissom, 28, of Petal, turned herself in to investigators with the Attorney General's Medicaid Fraud Control Unit following indictment by a Lamar County Grand Jury for depraved heart murder. Grissom is accused in the indictment of turning off the machines which were helping keep the alleged victim alive. Grissom was working as an R.N. at the facility where the alleged victim, 77, was receiving treatment.
February 26, 2014; Mississippi Attorney General: McComb Resident Pleads Guilty to Abuse of a Vulnerable Person
A McComb resident is going to prison for abuse of a vulnerable person, announced Attorney General Jim Hood today. Bryan Harris, 23, of McComb, appeared before Judge Michael Taylor in Lincoln County Circuit Court Monday and entered his guilty plea. Harris was sentenced to three years in the custody of the Mississippi Department of Corrections with one year and 364 days suspended and one year and one day to serve followed by one year and 364 days of supervised probation. Harris was ordered to pay a $250 fine, $250 to the Mississippi Crime Victims' Compensation Fund and $250 to cover costs of investigation.
February 26, 2014; Tennessee Department of Finance & Administration: Davidson Co. Woman Charged With TennCare Doctor Shopping
Nashville, TN - A Davidson County woman is charged in an indictment with TennCare fraud involving doctor shopping, or using the state's Medicaid benefits to go to multiple doctors in a short period of time in order to obtain controlled substances. The Office of Inspector General, with assistance from the Metro Nashville Police Department, today announced the arrest of 38-year old Linda A. Lewis, also known as Alexis Cooper and as India Cooper, of Nashville.
February 25, 2014; Massachusetts Attorney General: Easton Dentist to Pay $400,000 to MassHealth Over Improper Billing for Nursing Home Visits
BOSTON - An Easton dentist has agreed to pay $400,000 to the state's Medicaid program (MassHealth) to resolve allegations of improperly billing for visits to MassHealth members living in nursing homes, Attorney General Martha Coakley announced today.
February 25, 2014; Maryland Attorney General: AG Gansler: Caregiver Convicted of Assaulting a Vulnerable Adult
Baltimore, MD - Attorney General Douglas F. Gansler announced today that Ronald G. Barnes, 54, was convicted of Assault in the Second Degree following a two-day jury trial in the Circuit Court for Baltimore County. Barnes, of Lochearn, was employed as a driver/medical runner for L.I.F.E., Inc., a not-for-profit agency that provides residential, employment and day services to individuals with disabilities.
February 24, 2014; Mississippi Attorney General: Greenville Resident Going to Prison for Medicaid Fraud
A Greenville resident is going to prison for Medicaid Fraud, announced Attorney General Jim Hood today. Marguerite Wilson, 31, of Greenville, appeared before Judge Ashley Hines in Washington County Circuit Court today to be sentenced after pleading guilty to three counts of Medicaid Fraud in January. Wilson was sentenced to five years behind bars, with two to serve on each count and all to run concurrently. Restitution was ordered in the amount of $13,488.03. After serving her sentence, Wilson will remain on post release supervision until the restitution is paid in full. She was also ordered to pay $500 to the Mississippi Crime Victim Compensation Fund, as well as court costs and assessments.
February 24, 2014; Texas Attorney General: Former Medicaid Fraud Analyst Arrested
AUSTIN - Agents with the FBI and the Texas Attorney General's Office arrested former Medicaid Fraud analyst Augustine Nnadi Monday morning in Houston, Texas. According to the criminal complaint, Nnadi is charged with accepting more than $5,000 from a criminal defendant in exchange for assistance on a pending Medicaid Fraud case. If convicted of the federal charge, Nnadi faces up to 10 years in prison and a possible $250,000 fine.
February 24, 2014; Tennessee Department of Finance & Administration: Franklin Co. Woman Eluded Police 7 Months But Is Now Charged With TennCare Fraud
NASHVILLE, TN - After being on the run for the past seven months, a Franklin County woman has been charged in Rutherford County with falsely claiming dependent children in order to qualify for TennCare healthcare insurance benefits. The Office of Inspector General, with the assistance of Rutherford County Sheriff's Office, today announced the arrest of Wendy Farrell, 37, of Estill Springs.
February 24, 2014; Tennessee Department of Finance & Administration: Dickson Co. Woman Charged With TennCare Drug Fraud
NASHVILLE, TN - A Dickson County woman is charged with TennCare fraud in connection with obtaining prescription drugs through the state's Medicaid program and later selling a portion of the medication. The Office of Inspector General with the assistance of the 23rd Judicial District Drug Task Force and the Dickson County Sheriff's Office today announced the arrest of Erica Nicole Crow, 21, of Dickson.
February 21, 2014; Tennessee Department of Finance & Administration: Wilson Co. Man Charged With TennCare Drug Fraud
NASHVILLE, TN - A Wilson County man is charged with TennCare fraud for selling prescription drugs paid for by the state's Medicaid program. The Office of Inspector General today announced the arrest of Lincoln Jay Corona, 33, of Lebanon, after a joint investigation with the Wilson County Sheriff's Office.
February 21, 2014; Tennessee Department of Finance & Administration: Monroe Co. Woman Charged With TennCare Drug Fraud
NASHVILLE, TN - A Monroe County woman is charged in a McMinn Count indictment with TennCare fraud involving doctor shopping, or using TennCare to go to multiple doctors to obtain controlled substances. The Office of Inspector General with the assistance of the Monroe County Sheriff's Department today announced the arrest of Crystal Udovich, 31, of Sweetwater.
February 21, 2014;Georgia Attorney General: Florida Woman Sentenced to Prison for Medicaid Fraud
Jennifer C. Alsdorf, of Tampa, Fla., was sentenced February 19, 2014, by Judge Amy Totenberg in United States District Court for the Northern District of Georgia to four months imprisonment, nine months house arrest, restitution in the amount of $200,000, a $5,000 fine and 150 hours community service. She had previously entered her guilty plea in October of 2013 to one count of Medicaid Fraud for filing fraudulent claims with the Georgia Medicaid program.
February 20, 2014; Florida Attorney General: Attorney General Pam Bondi's Office Announces the Arrest of Mother and Daughter-in-Law Duo for More Than $70,000 of Medicaid Fraud
Tallahassee, Fla.-Attorney General Pam Bondi's Office announced the arrest of a mother and daughter-in-law duo for allegedly committing more than $70,000 in Medicaid fraud. Jennifer Kester and Lucy Watson allegedly ran a scheme that involved Kester and Watson billing the Medicaid program for services that were not actually provided to Watson's developmentally disabled son. According to the investigation, Watson, as the guardian of her son, submitted timesheets for work that was not provided.
February 20, 2014; Ohio Attorney General: Former Office Manager Indicted for Health Care Fraud
Ohio Attorney General Mike DeWine and U.S. Attorney for the Southern District of Ohio Carter Stewart announced today that the former office manager for the Cincinnati and Northern Kentucky office of Compass Healthcare, Inc., has been charged with four counts of Health Care Fraud. A federal grand jury indicted Beth Stein, 54, of Amelia, on the charges yesterday. The suspect is believed to have caused more than $100,000 in excessive billings to Medicare, Medicaid and other healthcare benefit providers.
February 19, 2014; Idaho Attorney General: Twin Falls Woman Sentenced to Prison in Medicaid Fraud Case
(Boise) - A Twin Falls woman has been sentenced to at least one year in prison as part of a scheme to fraudulently bill Medicaid for thousands of dollars in transportation services, Attorney General Lawrence Wasden said today. The judge also ordered 40-year-old Shaiyenne M. Anton to pay more than $47,000 in restitution to the Idaho Department of Health and Welfare, Division of Medicaid.
February 19, 2014; Tennessee Department of Finance & Administration: Dyer Co. Woman Charged With TennCare Drug Fraud
NASHVILLE, TN - A Dyer County woman is charged with TennCare fraud in connection with the sale of prescription drugs which were paid for by the state's Medicaid program. The Office of Inspector General today announced the arrest of Latoya Renee Nolen, 28, of Dyersburg, after a joint investigation with the Dyersburg Police Department.
February 18, 2014; Arkansas Attorney General: Baxter County Woman Convicted In Pill Theft
Little Rock - Attorney General Dustin McDaniel announced today that a Baxter County woman has been convicted of stealing pain medication that had been prescribed to residents of the long-term care facility where she worked.
February 18, 2014; Florida Attorney General: Attorney General's Office Announces Arrest of a Crestview Woman for More than $17,000 in Medicaid Fraud
Tallahassee, Fla. -Attorney General Pam Bondi's Medicaid Fraud Control Unit and the Okaloosa County Sheriff's Office arrested a Crestview woman for allegedly defrauding the Medicaid program out of more than $17,000 for services never rendered.
February 18, 2014; Tennessee Attorney General: Mental Health Facility Settles Billing Practices Case with the State
The A.I.M. Center, Inc. (AIM), which operates a community mental health facility located in Chattanooga, Tenn., has agreed to pay $800,000 to settle allegations that it violated the federal False Claims Act (FCA) and the Tennessee Medicaid False Claims Act (TNMFCA). This settlement resolves an investigation into AIM's billing practices which began with the filing of an action by a former member of the facility on behalf of the United States and the State of Tennessee under the qui tam, also known as whistle-blower, provisions of both the FCA and the TNMFCA. The United States and the State of Tennessee subsequently filed a joint intervention complaint.
February 18, 2014; Tennessee Department of Finance & Administration: Davidson Co. Woman Charged With TennCare Drug Fraud
NASHVILLE, TN - A Davidson County woman is charged with TennCare fraud for selling prescription drugs paid for by the state's Medicaid program. The Office of Inspector General today announced the arrest of Laurie Felice Levine, 51, of Nashville, after a joint investigation with Metro Nashville Police. She is charged with two counts of TennCare fraud in connection with using TennCare benefits to obtain prescriptions for the painkillers Oxymorphone and Oxycodone, later selling a portion of the prescriptions.
February 18, 2014; Tennessee Department of Finance & Administration: Two Dyer Co. Women Charged With TennCare Drug Fraud
NASHVILLE, TN - Two Dyer County women are each charged with TennCare fraud, both in connection with prescription drugs. The Office of Inspector General today announced the arrest of Dawonna W. Wiggins, 38, of Dyersburg and Gina A. Singleteary, 45, of Bogota. The arrests are the result of a joint effort with the Dyer County Police Department.
February 18, 2014; Tennessee Department of Finance & Administration: Humphreys Co. Woman Charged With TennCare Drug Fraud
NASHVILLE, TN - A Humphreys County woman is charged with 15 counts of TennCare fraud for passing forged prescriptions and using the state's Medicaid managed care program to pay for the prescriptions. The Office of Inspector General today announced the arrest of Linda Justice, 51, of McEwen, after a joint investigation with the Waverly Police Department. Justice, who was later arraigned in a Humphreys County Criminal Court, is a dental hygienist.
February 18, 2014; Tennessee Department of Finance & Administration: Two Women Charged With TennCare Fraud Ordered To Repay State - One Of The Women Lives In Mississippi, Was On Tenncare
NASHVILLE, TN - A Mississippi woman charged with falsifying statements in order to make herself eligible for TennCare must now repay the state. She and a Maryville woman have been sentenced for committing TennCare fraud. The Office of Inspector General today announced that Angela Brown, 32, of Horn Lake, Mississippi, was ordered to repay the state for benefits she received while she was on TennCare. A Shelby County Criminal Court ordered her to repay a total of $24,337.57 as part of her sentence on charges that she knowingly applied for TennCare benefits even though she lived in Mississippi and was not eligible for the program. District Attorney General Amy P. Weirich prosecuted the case. In a case in upper east Tennessee, a Blount County woman must also repay the state after being accused of receiving TennCare benefits even though she was not eligible. Amanda Church, 26, of Maryville, was ordered to repay $12,834.85, after pleading guilty to TennCare fraud, a Class E felony and theft of services over $1,000, a Class D felony. She also received three years of probation.
February 17, 2014; Kentucky Attorney General: General Conway Announces Indictment of Former Treatment Center Co-Owner
Attorney General Jack Conway and his Medicaid Fraud and Abuse Control Unit today announced that a former co-owner of a Barren County mental health treatment center has been indicted on charges involving theft and fraud. On January 31, the Barren County grand jury charged Jeremy Catron, 36, with theft by unlawful taking over $10,000 and devising or engaging in a scheme to defraud the Kentucky Medicaid program. Catron was arraigned this morning in Barren County Circuit Court and pleaded not guilty. A pretrial hearing was set for April 28.
February 14, 2014; U.S. Attorney; District of Columbia: Former District of Columbia Government Employee Pleads Guilty to Conspiring to Steal About $800,000 in Benefits
WASHINGTON - Aretha Holland-Jackson, a former employee of the District of Columbia Department of Human Services (DHS), pled guilty today to carrying out a scheme that defrauded the government of roughly $800,000 in Medicaid, food stamps, and other benefits.
February 14, 2014; Louisiana Attorney General: Kenner Woman Arrested For Stealing From Medicaid Patients
A Kenner woman has been arrested for stealing more than $133,000 from Louisiana Medicaid recipients, announced Attorney General Buddy Caldwell. Dina Maumus, 37, of 4228 Arkansas Avenue, surrendered this week to investigators with the Louisiana Attorney General's Medicaid Fraud Control Unit (MFCU). She was charged with twenty-four counts of Felony Theft.
February 12, 2014; Nebraska Attorney General: Omaha Mental Health Provider Pleads Guilty to Stealing Government Funds
Attorney General Jon Bruning today announced James Holt of Omaha pleaded guilty to stealing government funds in U.S. District Court in Lincoln. Holt's company, UMOJA, PC, pleaded guilty to one federal felony count of health care fraud and Holt pleaded guilty to nine federal misdemeanors. Holt is a mental health provider in Omaha.
February 11, 2014; New York Attorney General: A.G. Schneiderman Announces Arrests of Suffolk County Nursing Home Employees and Lawsuit against the Home's Owners Alleging Pattern Of Neglect
New York - Attorney General Eric T. Schneiderman today announced the arrests of nine employees of the Medford Multicare Center for Living, Inc. in Medford, New York. Seven of the arrests are in connection with the 2012 death of a 72-year-old resident who was at the facility for what was supposed to be temporary rehabilitation. The corporation operating the home and the facility's top administrator were also charged with trying to cover up the circumstances surrounding the death. The Attorney General separately filed a civil lawsuit today charging the home's owners with fraud, based on a long history of criminal conduct by employees of the home, and corporate looting.
February 11, 2014; Tennessee Department of Finance & Administration: Hawkins County Woman Charged With TennCare Fraud
Nashville, TN - A Hawkins County woman is charged with TennCare fraud for selling prescription drugs paid for by the state's Medicaid program. The Office of Inspector General today announced the arrest of Brandi Gail Collins, 34, of Church Hill, after a joint investigation with the Church Hill Police Department.
February 7, 2014; Florida Attorney General: Orange County Speech Therapist Arrested for Medicaid Fraud
TALLAHASSEE, Fla. -Attorney General Pam Bondi's Medicaid Fraud Control Unit and the Orange County Sheriff's Office have arrested an Orange County woman for Medicaid fraud. Tiffany Campbell, a licensed speech therapist, allegedly used falsified records to collect payment for services never rendered during the summer of 2013. According to the investigation, Campbell's employer billed Medicaid for more than $8,000 in speech therapy services never rendered based on Campbell's fraudulent logs.
February 7, 2014; Tennessee Department of Finance & Administration: Two Women Charged With TennCare Fraud In Hawkins Co.
NASHVILLE, TN - Two women are charged in Hawkins County in separate cases involving TennCare fraud. One of the women is charged with TennCare fraud for obtaining prescription drugs using a fraudulent prescription, and the other person is charged with TennCare fraud involving "doctor shopping."
February 7, 2014; Tennessee Department of Finance & Administration: Four Charged With TennCare Fraud In Humphreys Round-Up
NASHVILLE, TN - TennCare fraud charges have been lodged against four people in Humphreys County. The four are among 13 people arrested after a multi-agency undercover operation. The Office of Inspector General, working with the 23rd Judicial Drug Task Force and the Humphreys County Sheriff's Office, today announced the four also charged with TennCare fraud for selling prescription drugs.
February 6, 2014; Maryland Attorney General: AG Gansler Recovers $20,000 in Settlement with Rite Aid of Maryland
Baltimore, MD - Attorney General Douglas F. Gansler announced today that Maryland has reached a settlement agreement with Rite Aid of Maryland, Inc., resolving allegations that the pharmaceutical retailer had a practice of keeping both the payments and the prescriptions that had been returned as "undeliverable." Under the agreement, Rite Aid will pay $20,000 to the Maryland Medicaid Program, a portion of which will be shared with the federal government.
February 6, 2014; New Jersey Attorney General: Camden County Man Pleads Guilty to Distributing Prescription Narcotics to Undercover Investigator
Trenton - Acting Attorney General John J. Hoffman announced that a Camden County man pleaded guilty today to selling prescription narcotics to an undercover investigator.
February 6, 2014; New York Attorney General: A.G. Schneiderman Announces Guilty Plea By Long Island Senior Center Aide For Attempting To Steal More Than $10k From An 88-Year-Old Woman In Her Care
Hauppauge - Attorney General Eric T. Schneiderman today announced the guilty plea of Stephanie Benodin, a former personal care assistant at The Tuttle Center, a life care retirement community that is part of The Amsterdam at Harborside in Port Washington, N.Y. She admitted that she took the victim's check out of her checkbook, signed the victim's name without permission or authority, made the check payable to Benodin's mother for $10,000 and deposited it into her mother's bank account. The check was returned for insufficient funds.
February 6, 2014; Tennessee Department of Finance & Administration: Lauderdale Co. Woman Charged With TennCare, Food Stamp Fraud
Nashville, TN - A Lauderdale County woman is indicted for TennCare fraud and food stamp fraud for falsely reporting her income in order to obtain benefits from both government programs. The Office of Inspector General with the assistance of the Lauderdale County Sheriff's Office announced the arrest of Shandetra Theus, 32, of Ripley. She is charged with TennCare fraud, two counts of theft of services and Food Stamp fraud. Theus is accused of failing to report income to the state in order to qualify for the two programs.
February 6, 2014; Tennessee Department of Finance & Administration: Two Women Charged With TennCare Fraud In Lauderdale Co.
Nashville, TN - Two women are charged with TennCare fraud in Lauderdale County. One of the women is charged with TennCare doctor shopping and the other is accused of selling prescription drugs obtained with TennCare healthcare insurance benefits. The Office of Inspector General today announced the arrests: Brenda Faye Allen, 47, of Ripley, charged with four counts of fraudulently using TennCare to obtain a controlled substance by doctor shopping for controlled substances. The doctor's office visits and the prescriptions were paid for with TennCare benefits. Carissa Deawn White, 21, of Halls, charged with TennCare fraud and possession of a Schedule III controlled substance with the intent to deliver, after a joint investigation with the Halls Police Department. The drug involved, Hydrocodone, was paid for by TennCare.
February 6, 2014; Tennessee Department of Finance & Administration: Davidson Co. Woman Charged With TennCare Drug Fraud
Nashville, TN - A Davidson County woman is charged with TennCare drug fraud in an indictment accusing her of selling prescription drugs paid for by TennCare, the state's healthcare insurance program. The Office of Inspector General today announced the charges against Marilyn Ayers, 62, of Madison. She is charged with TennCare fraud along with three counts of sale of controlled substance in a drug free school zone and three counts of possession with intent to sell or deliver controlled substances in a drug free school zone.
February 5, 2014; New York Attorney General: A.G. Schneiderman Announces $250k Settlement With NY Foundling Hospital For Overbilling Medicaid
New York - Attorney General Eric T. Schneiderman today announced a $250,000 settlement with New York Foundling Hospital, a Manhattan-based provider of child foster care services. The settlement resolves allegations that New York Foundling was billing Medicaid for the care of children while they were absent from the program. As part of an ongoing review of child foster care agency books, the Attorney General's office has recouped $3.8 million in Medicaid funds from more than 65 child foster care facilities.
February 5, 2014; Tennessee Department of Finance & Administration: Davidson Co. Woman Charged With TennCare Drug Fraud
Nashville, TN - A Davidson County woman is charged with presenting a forged prescription and using TennCare healthcare insurance benefits to pay for the forgery. The Office of Inspector General today announced the arrest of Ashley C. Alexander, 26, of Nashville. Alexander was arrested after a joint investigation with Metro Nashville Police.
February 4, 2014; New York Attorney General: A.G. Schneiderman Announces Arrest Of Nursing Home Aide Who Injured A Resident And Failed To Seek Medical Help For Her
Batavia - Attorney General Eric T. Schneiderman today announced the arrest of Sarah Waclawski, 25, of Batavia, New York, a Certified Nurse Aide at Genesee County Nursing Home, for causing injury to a resident of the nursing home.
February 4, 2014; Wisconsin Attorney General: Milwaukee Man Sentenced for Medicaid Fraud
Madison - Attorney General G.B. Van Hollen announced today that a Milwaukee man has pleaded to and been convicted of Medicaid fraud for his part in a scheme to file false claims for fictitious durable medical equipment. Ferguson Saffold, Jr., appeared on February 3, 2014, before Milwaukee County Circuit Court Judge Dennis P. Moroney, who imposed and stayed a sentence of four years imprisonment - comprising two years initial confinement with two years extended supervision - and placed Saffold on probation for three years.
February 3, 2014; Wyoming Attorney General: Wyoming Medicaid Provider Indicted for Health Care Fraud
Cheyenne, WY- Wyoming Attorney General Peter Michael announced today that a Wyoming Medicaid provider was indicted for alleged health care fraud for billing Wyoming Medicaid for services she did not perform. Deborah Person of Cheyenne was indicted in the Federal US District Court of Wyoming on one count of federal health care fraud for allegedly billing Wyoming Medicaid more than $10,000 for services she did not provide. Ms. Person provided Medicaid services for developmentally disabled children.
February 3, 2014; New York Office of Medicaid Inspector General: Governor Cuomo Announces Record-Breaking $851 Million in Medicaid Recoveries
Governor Andrew M. Cuomo today announced the largest single year of recoveries of taxpayer dollars in the history of the Office of the Medicaid Inspector General (OMIG). Preliminary calculations show the administration recovered more than $851 million dollars for 2013. This brings the three-year total under Governor Cuomo to more than $1.73 billion recovered from Medicaid providers who inappropriately billed Medicaid and individuals who received services to which they were not entitled. This is a 34 percent increase over the previous three years. OMIG's recoveries are the highest on record for any state Medicaid program integrity unit.
February 3, 2014; Tennessee Department of Finance & Administration: Davidson Co. Woman Charged With TennCare Drug Fraud
Nashville, TN - A Davidson County woman is charged in nearby Wilson County with TennCare fraud in connection with using the state's Medicaid program to pay for fraudulent prescriptions for painkillers. The Office of Inspector General, with the assistance of the Wilson County Sheriff's Office, today announced the arrest of Jessica Houchin, 31, of Nashville.

January 2014

January 30, 2014; Florida Attorney General: Attorney General Pam Bondi's Office and Other Law Enforcement Agencies Arrest Three Levy County Residents for Medicaid Fraud
Tallahassee, Fla. -Following an investigation by Attorney General Pam Bondi's Medicaid Fraud Control Unit, three Levy County residents were arrested by the Levy County Sheriff's Office and the Chiefland Police Department. Allegedly Laurie Meeks and Stephanie Tindall fraudulently billed the Medicaid program for nearly $80,000 for services never rendered, and Barbara Gamble fraudulently billed the Medicaid program for more than $3,500 for services never rendered.
January 30, 2014; Arkansas Attorney General: Medicaid Fraud Arrest Announced
Little Rock - Attorney General Dustin McDaniel announced today that a Sebastian County health-care worker has been arrested for Medicaid fraud following an investigation by the Attorney General's Medicaid Fraud Control Unit.
January 29, 2014; New York Attorney General: A.G. Schneiderman Announces Settlement With EmblemHealth For Failing To Offer Continuation Coverage To Young Adults And Wrongfully Denying Claims For Medical Treatment
New York - After an investigation uncovered widespread violations of New York law requiring health insurers to offer young adults continuation health coverage on their parents' policies, Attorney General Eric T. Schneiderman announced today that his office has reached a settlement with EmblemHealth, Inc. ("Emblem"), a health insurance company that provides coverage to 3.4 million New Yorkers, through its Group Health Incorporated ("GHI") and Health Insurance Plan of Greater New York ("HIP") units. The settlement requires EmblemHealth to offer reinstatement of health coverage to more than 8,000 young adults whose coverage was wrongly terminated, and to pay approximately $90,000 in denied claims.
January 28, 2014; Wisconsin Attorney General: Beloit Woman Sentenced for Medicaid Fraud
Madison - Attorney General J.B. Van Hollen announced today that a Beloit woman has been sentenced in Walworth County on convictions for Medicaid fraud and falsification of patient health care records. Lara Skrzypczynski appeared before Walworth County Circuit Court Judge David M. Reddy on January 24, 2014, and was placed on probation for three years, with a condition of 90 days in jail. She also was ordered to pay $45,786.87 in restitution, with payments beginning on March 1, 2014; if she fails to make restitution, she may receive an additional six months in jail. Other probation conditions include AODA assessment and follow-through, mental health assessment and payment of court costs.
January 27, 2014; Alaska Attorney General: Municipality of Anchorage Employee Sentenced to One Year in Jail for Fraudulently Billing Medicaid $64,665.47
The Medicaid Fraud Control Unit (MFCU) successfully prosecuted 37 year old Lorie Nabong Batac for falsely billing Medicaid for personal care attendant (PCA) services. Batac worked full time for the Municipality of Anchorage as a property tax assessor and part time for Home Depot. The evidence collected by the MFCU showed that Batac often billed Medicaid for PCA services she claimed to be providing when she was in fact working at Home Depot or simultaneously billing for services provided to two different Medicaid recipients. The evidence further showed that Batac repeatedly billed for providing PCA services to Medicaid recipients while the recipients were traveling internationally or Batac was travelling domestically to Los Angeles and Hawaii. In total, Batac billed Medicaid $64,665.47 for services that were never performed.
January 27, 2014; New York Attorney General: A.G. Schneiderman Announces Arrest Of Doctor Who Illegally Sold Prescriptions
New York - Attorney General Eric T. Schneiderman today announced the arrest and arraignment of Daniel C. Gillick, a Youngstown, N.Y., doctor who allegedly sold prescriptions for a controlled substance to a Medicaid recipient, in exchange for the recipient returning half of the medication prescribed to him for each prescription.
January 27, 2014; Arkansas Attorney General: Craighead County Woman Arrested For Medicaid Fraud
Little Rock - Attorney General Dustin McDaniel announced today that a Craighead County health-care worker has been arrested for Medicaid fraud as part of an investigation by the Attorney General's Medicaid Fraud Control Unit. Amanda Fielder, 28, of Bono was arrested last week on one count of Medicaid Fraud, a Class C felony. She is accused of billing the state's Medicaid program for services she did not provide.
January 27, 2014; Tennessee Department of Finance & Administration: Claiborne Co. Woman Charged With TennCare Drug Fraud
Nashville, TN - A Claiborne County woman is charged with TennCare fraud for using the program to obtain prescription drugs, which she is charged with selling. The Office of Inspector General with the assistance of the Claiborne County Sheriff's Office and the New Tazewell Police Department today announced the arrest of Fallon Seals, 31, of Tazewell.
January 21, 2014; Tennessee Department of Finance & Administration: Sumner Co. Woman Charged With Doctor Shopping
Nashville, TN - A Sumner County woman is charged with doctor shopping, or going to multiple doctors to obtain similar prescriptions for drugs. The Office of Inspector General announced the arrest of 26-year old Katrina Bond, of Gallatin, who was charged by a Sumner County Grand Jury with five counts of fraudulently obtaining controlled substances by doctor shopping. Arrests occurred in both Sumner and Wilson Counties. Bond apparently failed to disclose she had seen other healthcare providers within a short time period and received the same or similar prescriptions for the painkiller Hydrocodone.
January 16, 2014; Tennessee Department of Finance & Administration: Cocke County Woman Charged 2nd Time With TennCare Fraud
Nashville, TN - A Cocke County woman is charged a second time with TennCare doctor shopping, or going to multiple doctors to obtain the same or similar controlled substances and using the state's Medicaid program as payment. The Office of Inspector General, with assistance from the Sevier County Sheriff's department, today announced the arrest of 20-year old Diamond Ahrens, of Newport. She was indicted in Sevier County on one count of doctor shopping for prescriptions to obtain the painkillers Hydrocodone and Tramadol. TennCare paid for the doctor visits.
January 21, 2014; Ohio Attorney General: Marysville Nurse Indicted in $200,000 Medicaid Fraud Scheme
Columbus, Ohio - Ohio Attorney General Mike DeWine today announced that a Marysville nurse has been indicted by a Franklin County Grand Jury on three felony counts related to a Medicaid fraud scheme.
January 21, 2014; Washington Attorney General: King County woman sentenced in Medicaid Fraud case
Olympia - A King County woman was sentenced today to a month of community service and ordered to pay full restitution after being convicted of First Degree Theft and four other felony counts of Medicaid False Statement.
January 16, 2014; Kansas Attorney General: Wilson County woman ordered to repay $50,000 for Medicaid Fraud
FREDONIA - (January 16, 2014) - A Wilson County woman was ordered today to repay more than $50,000 to the Kansas Medicaid program after pleading no contest to 15 charges of Medicaid Fraud, Kansas Attorney General Derek Schmidt said.
January 16, 2014; New York Attorney General: A.G. Schneiderman Announces Conviction Of Rochester Man Who Earned More Than $115k Posing As Optometrist And Ophthalmic Dispenser
ROCHESTER - Attorney General Eric T. Schneiderman today announced that his office secured guilty pleas in the criminal case of Shamil Tadros, of Rochester, NY, who fraudulently billed Medicaid and other payers for more than $115,000 for optometrist and/or ophthalmic dispensing services without ever having obtained a valid New York State license for either profession.
January 15, 2014; New York Attorney General: A.G. Schneiderman Announces Settlement With Health Care Insurer For Wrongfully Denying Mental Health Treatment Claims
NEW YORK - After an investigation uncovered the wrongful denial of hundreds of claims for nutritional counseling for mental health conditions, Attorney General Eric T. Schneiderman today announced that his office has reached a settlement with Cigna Corporation, requiring the health insurer to reprocess and pay hundreds of claims for nutritional counseling for mental health conditions, in particular eating disorders, to members who were wrongfully denied those benefits.
January 14, 2014; New York Attorney General: A.G. Schneiderman Announces Guilty Plea Of Nurse Who Abused Elderly Patient
ALBANY-- Attorney General Eric T. Schneiderman today announced the guilty plea of Sarina Francis, in connection with the abuse of a nursing home resident in August 2013, while Ms. Francis was employed as a Certified Nurse's Aide at the Hudson Park Rehabilitation and Nursing Center located at 325 Northern Boulevard in Albany, N.Y.
January 14, 2014; Florida Attorney General: Attorney General Bondi's Medicaid Fraud Control Unit Announces Arrest of Gainesville Woman
Tallahassee, Fla.-Following an investigation by Attorney General Pam Bondi's Medicaid Fraud Control Unit, the Alachua County Sheriff's Office arrested a Gainesville woman, Lakeisha Anne Roberson, on a felony warrant for Medicaid fraud and grand theft for allegedly defrauding the Medicaid program out of more than $12,000. The Florida Department of Children and Family Services referred the case to the Medicaid Fraud Control Unit.
January 10, 2014; Michigan Attorney General: Schuette Announces Felony Charges Against 11 In-Home Care Workers for Medicaid Abuse
Lansing - Attorney General Bill Schuette today announced felony charges against 11 individuals from across Michigan for allegedly abusing the Medicaid-funded Independent Living Services Program (Home Help Services Program). In many cases the defendants, who were often family members of the Medicaid beneficiaries, allegedly received checks for services rendered to the beneficiaries after they died.
January 10, 2014; Idaho Attorney General: Caldwell Couple Sentenced in Medicaid Fraud
Boise - A Caldwell couple convicted in a Medicaid fraud case has been ordered to pay $11,888 in restitution to the Idaho Department of Health and Welfare, Attorney General Lawrence Wasden said. The sentences were handed down by 4th District Judge Melissa Moody against Michael Wallace, 45, and his wife, Heather Wallace, 42.
January 10, 2014; Florida Attorney General: Attorney General Bondi's Office Announces Medicaid Fraud Conviction
Tallahassee, Fla. -Attorney General Pam Bondi announced the conviction of Lake County resident, Randall Ritch, for Medicaid fraud, operating an unlicensed health care clinic, and identity theft. Ritch pled guilty to four felony counts, and he was sentenced to 15 years of probation and was ordered to pay more than $83,000 in restitution to the Florida Medicaid program.
January 10, 2014; Florida Attorney General: Attorney General Pam Bondi's Office Arrests Two Marion County Residents for Battery of Person 65 Years or Older
Attorney General Bondi announced that the Medicaid Fraud Control Unit arrested Vincent Murano and Traci Nellis on charges of battery on a person 65 years of age or older and principal to battery.
January 10, 2014; New York Attorney General: A.G. Schneiderman Announces $40m Settlement Resolving Fraud Allegations Against Health Care Giant Carefusion
NEW YORK - Attorney General Eric T. Schneiderman today announced that New York has joined with 49 other states, the District of Columbia and the federal government in a global settlement with CareFusion, a California manufacturer of medical and surgical supplies and medical devices, resolving civil allegations of unlawful marketing practices and the payment of kickbacks aimed at promoting sales of CareFusion's surgical preparation solution, Chloraprep. San Diego-based CareFusion, a corporation spun off from Cardinal Health in 2009, allegedly promoted and marketed the solution for uses that were not approved by the U.S. Food and Drug Administration (FDA) and for uses that were not medically appropriate. Under the terms of agreement, unsealed today in U.S. District Court in Kansas, CareFusion will pay $40.1 million to the states and the federal government. New York's share is $2,067,976.04, plus accrued interest.
January 9, 2014; New York Attorney General: A.G. Schneiderman Announces $2.5 M Settlement with Rochester Home Health Agency for Defrauding Medicaid
New York - Attorney General Eric T. Schneiderman today announced a settlement with L. Woerner, Inc., which does business as Home Care of Rochester (HCR), resolving an investigation into false billings, including billing Medicaid for more than 6,500 hours of services provided by uncertified home health aides and aides who falsely inflated the hours they worked. The bulk of the company's fraudulent billing meant that Medicaid was charged for business costs unassociated with patient care, such as advertising. Under the agreement, HCR, located at 85 Metro Park in Rochester, will refund the Medicaid Program $2,503,932, plus interest.
January 9, 2014; Washington Attorney General: CareFusion Corp. to pay Washington $229,440 to resolve Medicaid fraud allegations
Olympia - Attorney General Bob Ferguson announced today that Washington has joined with other states and the federal government in a global settlement with CareFusion, a manufacturer of medical and surgical supplies and medical devices. The settlement resolves civil allegations of unlawful marketing practices and the payment of kickbacks for promoting sales of CareFusion's surgical preparation solution, Chloraprep. Under the terms of the civil settlement, CareFusion will pay a total of $40.1 million to the states and the federal government. Washington's total share of the settlement is $229,440 with nearly $109,448 returning directly to the state Medicaid program. Another $119,992 will be returned to the federal government for its share of Washington's Medicaid program. The federal government matches state funds to support the Medicaid program in Washington.
January 8, 2014; Kansas Attorney General: Independence man ordered to repay $13,000 for Medicaid Fraud
Independence - An Independence man was ordered Tuesday to repay more than $13,000 to the Kansas Medicaid program after pleading no contest to charges of Medicaid Fraud, Kansas Attorney General Derek Schmidt said. Walter Gibson, 43, was ordered to pay restitution in the amount of $13,292.19 to the Kansas Medicaid program by Judge Gary House in Montgomery County District Court. House also sentenced Gibson to 24 months of probation with an underlying sentence of 18 months in prison. Gibson pleaded no contest in November to charges of aiding a felon, making a false statement to the Medicaid program, unlawful acts relating to the Medicaid program and computer crimes.
January 8, 2014; Florida Attorney General: Attorney General's Office Arrests Naples Woman for More Than $60,000 in Medicaid Fraud
Tallahassee, Fla. -Attorney General Pam Bondi announced today that her office arrested a Naples woman on charges of Medicaid fraud and grand theft for allegedly defrauding the Medicaid program out of more than $60,000. Barbara Hilliard Brown was arrested today on a felony warrant by investigators from the Attorney General's Medicaid Fraud Control Unit, with assistance from the Collier County Sheriff's Office. The Florida Agency for Persons with Disabilities referred the case to the Medicaid Fraud Control Unit.
January 7, 2014; Texas Attorney General: Texas Attorney General's Office Secures $25 Million Agreement with Drug Manufacturer over Medicaid Fraud Allegations
AUSTIN - Texas Attorney General Greg Abbott today announced the resolution of a civil Medicaid fraud investigation that will yield more than $10 million for the State of Texas. According to the State's investigation, New York-based pharmaceutical manufacturer Hi-Tech Pharmacal Co., Inc. reported fraudulently inflated generic drug prices to the Medicaid program.
January 7, 2014; New York Attorney General: A.G. Schneiderman Announces Two-Year Prison Term For Licensed Practical Nurse In NYC Home Care Scam
QUEENS -- Attorney General Eric T. Schneiderman today announced that Roxanne McKen, a licensed practical nurse from Baldwin, N.Y., hired to provide home care for a seriously disabled child, was sentenced to two years in prison for stealing nearly $940,000 from the New York State Medicaid program by billing for hours she did not work or that were paid by a private insurance policy during a seven-year period.
January 6, 2014; Maryland Attorney General: Home Health Care Company Pays $500K in Fraud Settlement
Baltimore, MD - Attorney General Douglas F. Gansler announced today that A1 Reliable Medical & Healthcare Services, Inc. ("Reliable"), based in Pikesville, will pay $500,000 to the State of Maryland to resolve allegations that the company submitted improper claims for payment to the Medicaid program.
January 3, 2014; Maryland Attorney General: AG Gansler Secures Settlement from Baltimore County Dentist - Owner of Baltimore city practice must repay $25K to Medicaid program
Baltimore, MD - Attorney General Douglas F. Gansler announced today that the State of Maryland has reached an agreement with Lisa Valentine, D.D.S., of Woodstock, for her to repay the Medicaid program $25,000 in civil damages for services that were billed, but never rendered. The Medicaid Fraud Control Unit of the Office of the Attorney General conducted an investigation into the practice of Dr. Valentine, which included numerous interviews with her former patients and staff.
January 2, 2014; New Jersey Office of State Comptroller: State Comptroller's Office Seeks to Bar Three New Jersey Health Care Facilities from the Medicaid Program
The Office of the State Comptroller filed a $2.7 million claim today against a group of health care facilities in Neptune and Lawrenceville that are alleged to have submitted thousands of improper Medicaid reimbursement claims in order to obtain compensation to which they were not entitled.
January 2, 2014; Oklahoma Attorney General: Oklahoma City Counselor Sentenced to Prison for Medicaid Fraud
Oklahoma City - Laurel Mitchell-Hunt of Oklahoma City has been sentenced to 21 months in prison for Medicaid fraud, Attorney General Scott Pruitt announced Thursday. Mitchell-Hunt, 59, pled guilty to one count of Medicaid fraud in October in federal court and was sentenced to prison on Monday. Mitchell-Hunt, a licensed drug and alcohol counselor, billed the Oklahoma Health Care Authority for counseling sessions that were never provided.

December 2013

December 30, 2013; Tennessee Department of Finance & Administration: Marshall Co. Woman Charged With TennCare Fraud
Nashville, TN - A Marshall County woman is charged with TennCare fraud after receiving healthcare insurance benefits through the state's Medicaid managed care program, even though she was not eligible for benefits. The Office of Inspector General today announced the charges against Gena Leigh Garton, 33, of Chapel Hill.
December 24, 2013; Vermont Attorney General: Caregiver Charged With Medicaid Fraud
Michelle Pearce, age 35, of Winooski, Vermont, was arraigned today in Vermont Superior Court for Windsor County on four felony counts of Medicaid Fraud. According to court documents, Ms. Pearce was employed as the caregiver for a minor child with special needs enrolled in the Children's Personal Care Services program. She is alleged to have submitted thirty-nine timesheets purporting to have provided 461.5 hours of care when the child was actually enrolled in school, resulting in approximately $4,500 in overpayments by the Vermont Medicaid program.
December 20, 2013; Tennessee Department of Finance & Administration: Tipton Co. Woman Charged With TennCare Doctor Shopping
Nashville, TN - A Tipton County woman is charged in nearby Dyer County for TennCare fraud involving doctor shopping, or going to multiple doctors to obtain controlled substances and using the state's Medicaid program as payment. The Office of Inspector General, with assistance from the Dyer County Sheriff's Office, today announced the arrest of Kristy Morrow Valley, also known as Kristy Morrow Roberts, 32, of Drummonds.
December 19, 2013; Florida Attorney General: Attorney General Bondi Announces Arrest of Miami Woman for More Than $395,000 in Medicaid Fraud
TALLAHASSEE, Fla. -Attorney General Pam Bondi today announced that her office has arrested Lana Goldfinger for alleged Medicaid fraud. According to an investigation by the Attorney General's Medicaid Fraud Control Unit, Goldfinger allegedly conspired to commit Medicaid fraud by submitting false invoices from Pines Nursing Home totaling more than $395,000. Investigators with the Medicaid Fraud Control Unit acted on a referral from the Agency for Health Care Administration.
December 17, 2013; New York Attorney General: A.G. Schneiderman Announces Settlement With North Country Medicaid Provider
Potsdam - Attorney General Eric T. Schneiderman today announced that his office has reached a settlement with Health Services of Northern New York, Inc. for receiving overpayments from Medicaid for personal care aide services and certified home health agency services for the period from January 1, 2005 to December 31, 2012. An investigation and audit by the Attorney General's Medicaid Fraud Control Unit found that Health Services had submitted incorrectly completed cost reports for the years 2003 to 2010, which affected the reimbursement rate it received from Medicaid.
December 19, 2013; Tennessee Department of Finance & Administration: Warren Co. Woman Charged With TennCare Doctor Shopping
Nashville, TN - A Warren County woman is charged with TennCare fraud involving doctor shopping, or using the state's Medicaid managed care program to go to multiple healthcare providers in order to obtain controlled substances. The Office of Inspector General, with assistance from sheriff's officers in Warren and White counties, today announced the arrest of Iris Quinn, 52, of Sparta, Tennessee.
December 18, 2013; Arkansas Attorney General: Little Rock Woman Convicted Of Medicaid Fraud
Little Rock - A Little Rock woman arrested earlier this year after an investigation by the Attorney General's Medicaid Fraud Control Unit has been convicted of felony Medicaid Fraud, Attorney General Dustin McDaniel announced today. Tequila Fitzgerald, 22, pleaded guilty to one count of Medicaid Fraud, a Class B felony, in Pulaski County Circuit Court on Tuesday. Circuit Judge Herbert Wright sentenced Fitzgerald to five years of probation. She was fined $28,459.44 and ordered to pay restitution of $9,468.48 to the Arkansas Medicaid program.
December 18, 2013; Vermont Attorney General: Seven Individuals Charged With Medicaid Fraud Related To In Home/Community-Based And Personal Care Services That Were Not Provided
Seven individuals enrolled as either caregivers or employers-of-record in Vermont's Medicaid-funded Home and Community Based (HCBS) or Personal Care programs were separately arraigned today in Vermont Superior Court for Windsor County on felony counts of Medicaid Fraud for allegedly billing for care to children and vulnerable adults that was not provided.
December 16, 2013; Arizona Attorney General: Attorney General Tom Horne Announces Conviction of Woman Who Faked Leukemia
Phoenix, AZ - Attorney General Tom Horne is today announcing the conviction of Natasha Lee Leatherman, for committing the criminal offenses of fraudulent schemes and artifices and obtaining a narcotic drug by fraud. Between January 2011 and March 2013, Leatherman defrauded the Arizona Health Care Cost Containment System program of tens of thousands of dollars in benefits. Her drug addiction led her to health care facilities in Yavapai County, where she received treatment for a feigned illness.
December 16, 2013; Tennessee Department of Finance & Administration: Davidson Co. Woman Charged With TennCare Doctor Shopping
Nashville, TN - A Davidson County woman is charged in a Lincoln County indictment with TennCare fraud involving doctor shopping, or using the state's Medicaid program to go to multiple doctors in order to obtain prescriptions for a controlled substance. The Office of Inspector General, assisted by Metro Nashville Police, today announced the arrest of Sherry Ryan, 32, of Nashville. She's charged with two counts of fraudulently using TennCare to obtain a controlled substance by doctor shopping. In addition, Ryan was charged with two counts of obtaining a controlled substance by fraud.
December 13, 2013; Louisiana Attorney General: Medicaid Fraud Control Unit Arrests Man Impersonating Mental Health Professional
Medicaid Fraud Control Unit agents arrested 44-year-old Temmie Uzzell this week and charged him with one felony count of Medicaid fraud for falsifying his diploma in order to work as a Mental Health Professional at a Monroe-based Medicaid services provider.
December 13, 2013; Tennessee Department of Finance & Administration: Three In Dyer County Charged With TennCare Fraud
Nashville, TN - Two men and a woman are charged with TennCare fraud in a Dyer County indictment for selling prescription drugs paid for by TennCare. The Office of Inspector General today announced the arrests of Lateia Cruse, 20, and Raymond Thomas, 42, both of Dyersburg, and Thomas Moore, 55, of Trimble. These arrests are the result of a joint effort with the Dyersburg Police Department.
December 12, 2013; Louisiana Attorney General: Baton Rouge Optometrist Indicted on Medicaid Fraud Charges
An East Baton Rouge Parish grand jury has returned a three count indictment against a Baton Rouge optometrist for charges related to defrauding the Louisiana Medicaid Program, according to criminal prosecutors with the Louisiana Attorney General's Medicaid Fraud Control Unit.
December 12, 2013; Tennessee Department of Finance & Administration: Cannon Co. Woman Arrested After Months On The Run From TennCare Fraud Charges
Nashville, TN - After being on the run for almost a year, a Cannon County woman has been arrested a second time for TennCare fraud involving doctor shopping, or using TennCare to go to multiple doctors to obtain controlled substances. The Office of Inspector General, with assistance from the Cannon County Sheriff's Office, today announced the arrest of Kimberly Besner, 39, of Woodbury. She is charged in an indictment issued in January of this year with three counts of fraudulently obtaining controlled substances by doctor shopping for prescriptions for the painkiller Hydrocodone, using TennCare healthcare insurance benefits as payment.
December 11, 2013; Tennessee Department of Finance & Administration: Blount County Woman Charged With TennCare Fraud
Nashville, TN - A Blount County woman is charged with TennCare fraud and theft of services after receiving healthcare insurance benefits through the state's Medicaid managed care program, even though she was not eligible. The Office of Inspector General today announced the arrest of Amanda Church, 26, of Maryville. She is charged with two counts of TennCare fraud and two counts of theft of services. The Blount County Sheriff's Office assisted in Church's arrest.
December 12, 2013; Washington State Office of the Attorney General: King County woman enters guilty plea in Medicaid Fraud case ; Billed Medicaid for four months after client's death
OLYMPIA - A King County woman entered a guilty plea today in Thurston County Superior Court after the Attorney General's Office (AGO) Medicaid Fraud Control Unit (MFCU) charged her with First Degree theft and four other felony counts of Medicaid False Statement.
December 11, 2013; Florida Office of the Attorney General: Attorney General Bondi's Office Announces Arrest of Lake County Couple for Nearly $80,000 Medicaid Fraud
TALLAHASSEE, Fla.-Attorney General Pam Bondi announced that James and Grisselle Davis, owners of Kingdom Builders Ministries, were arrested for allegedly defrauding Florida's Medicaid program out of nearly $80,000. An investigation conducted by the Attorney General's Medicaid Fraud Control Unit revealed that the couple allegedly billed the Medicaid program for nearly $80,000 for targeted case management services that were never rendered. Targeted case management services are designed to link Medicaid recipients with a documented mental health condition to services in the community. The Lake County Sheriff's Office assisted with the arrests.
December 6, 2013; New Jersey Attorney General: Operators of Middlesex County Medical Supply Store Sentenced to State Prison for Defrauding Medicaid Out of More Than $150,000
Trenton - Acting Attorney General John J. Hoffman announced that the operators of a Middlesex County medical supply store were sentenced to state prison today for their roles in a scheme to defraud the New Jersey Medicaid program out of at least $150,000. Marina Finkel, 50, of Old Bridge, and Yelena Medvedik, 41, of Holmdel, were each sentenced to three years in state prison by Superior Court Judge Anthony J. Mellaci, Jr. in Monmouth County. The defendants were also ordered to pay a total of $300,000, which includes restitution and a civil penalty. Finkel and Medvedik will also be debarred from participating in the Medicaid program for eight years.
December 6, 2013; Wisconsin Attorney General: Attorney General J.B. Van Hollen announced today that a Beloit woman has been convicted of Medicaid fraud.
Madison - Attorney General J.B. Van Hollen announced today that a Beloit woman has been convicted of Medicaid fraud. Lara Skrzypczynski appeared in Walworth County Circuit Court on December 5, 2013 and entered pleas of guilty to Medicaid fraud, a felony and falsification of patient health care records, a misdemeanor. She agreed to make restitution of $45,786.87 to the State. Sentencing was adjourned to January 24, 2014, to allow the defendant time to schedule witnesses to testify on her behalf.
December 6, 2013; Tennessee Department of Finance & Adminstration: Meigs County Woman Charged With TennCare Drug Fraud
Nashville, TN - A Meigs County woman is charged with TennCare fraud related to selling prescription drugs paid for by the state's Medicaid program. The Office of Inspector General today announced the arrest of Tonya Jillane Bunch, 39, of Decatur. The arrest is the result of a joint effort with the Meigs County Sheriff's Office.
December 5, 2013; New York Attorney General: A.G. Schneiderman, State Comptroller DiNapoli & DOI Commissioner Gill Hearn Announce Arrest of Not-For-Profit Executive in Six-Year Theft Scheme
New York - Attorney General Eric T. Schneiderman, Comptroller Thomas DiNapoli and New York City Department of Investigation (NYC DOI) Commissioner Rose Gill Hearn today announced the arrest of a nonprofit executive accused of pocketing taxpayer dollars intended for public services and capital improvements in New York City. A multi-agency joint investigation, including NYC DOI and two federal agencies, exposed the theft of approximately $373,000 in public funds provided by New York State, the New York City Council, and federal earmark grants.
December 3, 2013; Tennessee Department of Finance & Administration: DeKalb Co. Man Charged With TennCare Drug Fraud
Nashville, TN - A DeKalb County man is charged with TennCare fraud for using the state's Medicaid program to pay for fraudulent prescriptions for controlled substances. The Office of Inspector General, with the assistance of the DeKalb County Sheriff's Office, today announced the arrest of Jackie Ervin, 36, of Smithville. He is charged with three counts of TennCare fraud and three counts of obtaining a controlled substance by fraud. An indictment accuses Ervin of presenting forged prescriptions for the painkiller Lortab and Adderrall, an amphetamine, using TennCare benefits to pay for the forged prescriptions.
December 3, 2013; Tennessee Department of Finance & Administration: Warren Co. Woman Charged With TennCare Drug Fraud
Nashville, TN - A Warren County woman is charged with TennCare fraud for selling prescription drugs paid for by the state's healthcare insurance program. The Office of Inspector General today announced the arrest of Joyce Ann Brown, 57, of McMinnville, after a joint investigation with the McMinnville Police Department and the Warren County Sheriff's Office. Brown is charged with TennCare fraud, sale of a Schedule II controlled substance and delivery of a Schedule II controlled substance. Charges accuse her of obtaining the painkiller Morphine using TennCare benefits and delivering a portion of the drugs to a buyer.

November 2013

November 27, 2013; Mississippi Attorney General: Owner of Jackson Eye Clinic Arrested for Medicaid Fraud
The owner of a Jackson eye clinic is facing charges of Medicaid Fraud, announced Attorney General Jim Hood today. Barbara Faye Jones , 30, of Jackson, turned herself into authorities with the Attorney General's Medicaid Fraud Control Unit Tuesday following recent indictment by a Hinds County grand jury.
November 26, 2013; Massachusetts Attorney General: Two Brockton Residents Plead Guilty to Defrauding $107,000 From State's Medicaid Program
BROCKTON - Two Brockton residents have pleaded guilty to making claims of payments for personal care services that were not actually provided, causing an overpayment of about $107,000 in funds from the state's Medicaid Program (MassHealth), Attorney General Martha Coakley announced today.
November 26, 2013; Washington Attorney General: Mother and son plead guilty to stealing $17,696 from state healthcare programs
SPOKANE - The Washington State Attorney General's Office today announced that a mother and son, who were contracted to provide care to a home-healthcare program client in Spokane, pleaded guilty to stealing $17,696 from state and federal health care programs.
November 25, 2013; Georgia Attorney General: Metro Atlanta Dentist Pleads Guilty to Fraudulently Billing Georgia Medicaid over $2 Million
On Friday, November 22, 2013, Kenneth Morris Wiggins, Jr. pleaded guilty to one felony count of Medicaid Fraud (O.G.G.A. § 49-4-146.1(b)) in Cobb County Superior Court. Wiggins was paid over $2,230,000 by Georgia Medicaid as a result of his fraudulent billing practices.
November 22, 2013; Georgia Attorney General: Registered Nurse Charged with Claiming to Treat Deceased Medicaid Patient
On Tuesday, November 19, 2013, a Fulton County Grand Jury indicted Jeannette Mary Hokanson on 19 felony counts, including Identity Fraud (O.C.G.A. § 16-9-120), Forgery in the First Degree (O.C.G.A. § 16-9-1) and False Statements and Writings (O.C.G.A. § 16-10-20).
November 22, 2013; Tennessee Department of Finance & Administration: Claiborne Co. Woman Charged With TennCare Fraud
Nashville, TN - A Claiborne County woman is charged with TennCare fraud for selling prescription drugs paid for by the state's Medicaid program. The Office of Inspector General today announced the arrest of Leann Davis Johnston, 47, of New Tazewell, after a joint investigation with the Claiborne County Sheriff's Office.
November 22, 2013; Florida Attorney General: Attorney General Bondi's Office Arrests Lee County Man on Medicaid Fraud Charges
Attorney General Bondi announced that her office, along with the Lee County Sherriff's Office, has arrested a Lee County man for Medicaid fraud. Paul Latham is charged with billing the Medicaid program for home support services he did not provide.
November 21, 2013; Maryland Attorney General: Attorney General Gansler Secures Settlement with Salisbury Periodontist
Baltimore, MD - Attorney General Douglas F. Gansler announced today that the State of Maryland has reached an agreement with Stewart Perim, D.D.S., of Salisbury, requiring him to repay the Medicaid program $340,000 in civil damages. An investigation showed the Dr. Perim, a board-certified periodontist who also specializes in orthodontics, billed the Medicaid program for services that were not rendered, including bite adjustments, fillings and appointments for office visits.
November 20, 2013; Louisiana Attorney General: Attorney General Recovers $238 Million from Pharmaceutical Companies Engaged in Fraudulent Drug-Pricing Scheme
Louisiana Attorney General Buddy Caldwell announced today the successful conclusion to a three year effort against more than 100 pharmaceutical companies and their subsidiaries that fraudulently raised drug prices paid by Louisiana taxpayers through the Medicaid program.
November 20, 2013; Tennessee Department of Finance & Administration: Rutherford Co. Man Charged With TennCare Fraud
Nashville, TN - A Rutherford County man is charged with TennCare fraud for apparently selling prescription drugs paid for by the state's Medicaid program. The Office of Inspector General today announced the arrest of Dylan J. Wade, 18, of Smyrna, after a joint investigation with the Smyrna Police Department.
November 20, 2013; Tennessee Department of Finance & Administration: Davidson Co. Woman Charged With TennCare Doctor Shopping
Nashville, TN - A Davidson County woman is charged with TennCare fraud involving doctor shopping, or using TennCare to go to multiple doctors to obtain controlled substances. The Office of Inspector General today announced the arrest of Tracy L. Sanders, 36, of Nashville. She is charged with five counts of fraudulently obtaining controlled substances by using TennCare to pay for physician office visits, the prescription drugs, or both.
November 19, 2013; New York Attorney General: A.G. Schneiderman Announces Plea Of Ringleader In Rochester Oxycontin Ring
ROCHESTER - Attorney General Eric T. Schneiderman today announced that Shantel Williams, the ringleader of a scheme to illegally obtain and fill Oxycontin prescriptions for profit, has pleaded guilty. Charged as part of a joint prosecution with the U.S. Attorney's Office, Williams had access to her employer's prescription pad and used it to write approximately 25 fraudulent prescriptions for her co-defendants for 80-mg doses of Oxycontin. Three of the five defendants previously pleaded guilty.
November 18, 2013; Massachusetts Attorney General: Former Personal Care Manager Pleads Guilty in Connection with Billing MassHealth for Services Not Provided
Springfield - A Holyoke woman charged with managing personal care assistance has pleaded guilty to billing the state's Medicaid program (MassHealth) for services provided by her brother who was in jail at the time, and for a MassHealth member who was deceased, Attorney General Martha Coakley announced today.
November 18, 2013; Nevada Attorney General: Attorney General Masto Announces Conviction Of Behavioral Health Company For Medicaid Fraud
Las Vegas, NV - Nevada Attorney General Catherine Cortez Masto announced that Unity Family Services, Inc. (Unity), in accord with a negotiated settlement, was convicted today for the felony offense of submission of false Medicaid claims for fraud involving submission of billing to Medicaid for various behavioral health services that were never provided to Medicaid recipients.
November 15, 2013; Florida Attorney General: Attorney General Bondi's Office Arrests New Port Richey Resident for Medicaid Fraud
Attorney General Bondi's Medicaid Fraud Control Unit has arrested Dawn M. Poole for allegedly defrauding Florida's Medicaid program out of more than $2,000. Poole was contracted to provide personal care and therapy services to a disabled adult, but it is alleged that she frequently left early or submitted billing on days she was not present.
November 15, 2013; Kentucky Attorney General: General Conway Announces Arrest Following Investigation by OAG Medicaid Fraud and Abuse Control
Attorney General Jack Conway today announced the arrest and indictment of a Lexington, Ky. man following an investigation by General Conway's Office of Medicaid Fraud and Abuse Control. A Fayette County grand jury indicted 28-year-old Ahmad Davis on one count of theft by deception of more than $10,000 and one count of devising or engaging in a scheme to defraud the Kentucky Medical Assistance Program over $300.
November 15, 2013; Kentucky Attorney General: General Conway Announces Indictment of Northern Kentucky Doctor
Attorney General Jack Conway today announced the indictment of a chiropractic clinic owner in northern Kentucky on charges that she conspired to defraud a federal health care benefit program. A federal grand jury in Covington returned the indictment charging 47-year-old Dr. Andrea Almond, of Cincinnati, with one count of conspiracy to commit health care fraud.
November 15, 2013; New York Attorney General: A.G. Schneiderman Announces Charges Of Criminally Negligent Homicide Against Ambulette Driver In Death Of 86-Year-Old Passenger
Attorney General Eric T. Schneiderman announced today that a Bronx County grand jury returned an indictment charging Juan Garcia, a former ambulette driver, with criminally negligent homicide for causing the death of an 86-year-old nursing home resident. The passenger, a resident of Gold Coast Care Center of the Bronx, died one month after she was seriously injured when she was ejected from her wheelchair during medical transport. The indictment filed against Garcia also charges him with Endangering the Welfare of an Incompetent or Physically Disabled Person. Garcia faces up to 4 years in prison.
November 15, 2013; Tennessee Department of Finance & Administration: Mississippi Woman Charged With TennCare Fraud
Nashville, TN - A Mississippi woman is charged with misrepresenting her residency in order to obtain healthcare insurance benefits through the TennCare program. The Office of Inspector General today announced the arrest of Washett Spears-Whiting, 34, of Southaven, Mississippi. The Shelby County Sheriff's Office assisted in the arrest.
November 15, 2013; Tennessee Department of Finance & Administration: Three People Convicted Of Tenncare Fraud
Nashville, TN - Three people charged in separate TennCare fraud cases have been ordered to pay $15,884.93 in restitution to the state and court fines.
November 15, 2013; Tennessee Department of Finance & Administration: Humphreys County Woman Must Repay State For TennCare Benefits
Nashville, TN - A Humphreys County woman charged with TennCare fraud in both Humphreys and Wilson Counties has been ordered to repay the state for benefit received from the healthcare insurance program. Lisa A. Herlein, 39, of McEwen, was most recently charged in July by the Office of Inspector General in Wilson County in connection with falsely claiming dependent children in order to qualify for TennCare benefits.
November 14, 2013; Mississippi Attorney General: Personal Care Home Operator in Hattiesburg Arrested Second Time on Exploitation Charges
A Hattiesburg resident, already facing charges of exploitation of a vulnerable person, has been arrested on two additional counts of exploitation, announced Attorney General Jim Hood today. Juanita J. Goff, aka Janie Goff, age 67, of Hattiesburg was arrested Wednesday morning by investigators of the Attorney General's Medicaid Fraud Control Unit with assistance from the Forrest County Sheriff's Office and the Mississippi State Department of Health.
November 14, 2013; Nevada Attorney General: Attorney General Masto Announces Sentencing of Yolanda Rodriguez, Las Vegas Personal
Care Assistant
Las Vegas, NV - Nevada Attorney General Catherine Cortez Masto announced that Yolanda Rodriguez, 53, of Las Vegas, was sentenced today in a Medicaid fraud case involving the failure to maintain adequate records to support Medicaid claims
November 13, 2013; Connecticut State Attorney's Office: East Hartford Doctor Convicted Of Medicaid Fraud
An East Hartford doctor pleaded no contest today to billing the state's Medicaid program for an office visit during which he sexually assaulted a patient. Edwin Amobi Njoku, age 53, of Burnside Avenue in East Hartford, was convicted in Hartford Superior Court of one count of Larceny in the Second Degree By Defrauding A Public Community, a class C felony.
November 12, 2013; Tennessee Department of Finance & Administration: Rutherford Co. Man Charged With TennCare Drug Fraud
Nashville, TN - A Rutherford County man is charged with TennCare fraud in connection with selling prescription drugs which were paid for by TennCare, the state's Medicaid program. The Office of Inspector General today announced the arrest of Mark W. Morrow, 21, of Smyrna, after a joint investigation with the Smyrna Police Department.
November 12, 2013; Tennessee Department of Finance & Administration: Two Charged With TennCare Fraud In Robertson Co. Roundup
Nashville, TN - TennCare fraud charges are lodged against two people in a Robertson County roundup stemming from an undercover investigation involving prescription drugs. The Office of Inspector General today announced the arrests involving TennCare fraud: Desiree Elizabeth Jernigan, 29, of Greenbrier, charged with TennCare fraud, along with sale and delivery of a Schedule II controlled substance. She's accused of using TennCare to obtain a prescription for Adderall, an anti-anxiety medication, and selling a portion to an undercover agent. She was also charged with sale and delivery of Clonazepam, another anti-anxiety medication, which she obtained through means other than TennCare. Leo Hugh Rose, 55, of Adams, charged with TennCare fraud, as well as sale and deliver of a controlled substance for using TennCare benefits to obtain the painkiller Hydrocodone, and later selling it to an undercover agent.
November 8, 2013; Florida Attorney General: Attorney General Bondi's Office Prosecutes Miami-Dade County Billing Agent for Defrauding Medicaid Out of Nearly $300,000
Tallahassee, Fla. -Attorney General Pam Bondi's Office of Statewide Prosecution successfully prosecuted Miami-Dade County billing agent Gregory Campbell for defrauding Florida's Medicaid program out of nearly $300,000. According to an investigation by the Attorney General's Medicaid Fraud Control Unit, Campbell billed the Medicaid program for services never rendered. This case was based on a referral from the Agency for Health Care Administration.
November 8, 2013; Tennessee Department of Finance & Administration: Three Claiborne Co. Residents Charged With TennCare Drug Fraud
NASHVILLE, TN - Three people in Claiborne County are charged with TennCare fraud. The Office of Inspector General today announced the arrests, which come after a joint investigation with the Claiborne County Sheriff's Office. The three charged Mary Lou Price, 60, of Tazewell, charged with TennCare fraud, sale of a Schedule II controlled substance and delivery of a Schedule II controlled substance. The charges say she obtained the painkiller Oxycodone by using TennCare benefits, while planning to unlawfully distribute a portion of the prescription; Melinda H. Taylor, 41, and Delores K. Miller, 42, both of Speedwell, are each charged with TennCare fraud, and two counts each of sale of a Schedule III controlled substance and delivery of a Schedule III controlled substance. They are each accused of using TennCare benefits to obtain Hydrocodone and selling a portion of it on two separate occasions.
November 5, 2013; Wisconsin Attorney General: Attorney General J.B. Van Hollen Announces Settlement with McKesson and First Databank
MADISON - Attorney General J. B. Van Hollen announced that the State has reached an agreement in litigation charging pharmaceutical wholesaler McKesson Corporation and publisher First DataBank, Inc. with defrauding the Wisconsin Medicaid program. A Department of Justice law enforcement action filed in Dane County alleged that McKesson and First DataBank conspired to violate the Wisconsin Medicaid fraud statute, Deceptive Trade Practices Act, and False Claims Act by inflating reported drug prices to increase pharmacies' reimbursement from Wisconsin Medicaid.
November 5, 2013; Tennessee Department of Finance & Administration: Davidson Co. Woman To Repay State After Pleading Guilty To TennCare Fraud
Nashville, TN - A Davidson County woman charged with fraudulently obtaining TennCare benefits by falsely claiming her minor children were in the home in order to qualify must now repay the state for healthcare insurance benefits she received during the time she was on the program. The Office of Inspector General today announced that 29-year old Ryan Deette Wagoner, of Nashville, pleaded guilty to TennCare fraud.
November 5, 2013; Tennessee Department of Finance & Administration: Knox Co. Woman Charged In Dickson Co. With TennCare Drug Fraud
Nashville, TN - A Knox County woman is charged in Dickson County with using family members' TennCare benefits to pay for forged prescriptions at a Dickson pharmacy. The Office of Inspector General and the 23rd Judicial District Drug Task Force today announced the arrest of Michelle Ann Henson, 36, of Knoxville.
November 4, 2013; Nevada Attorney General: Attorney General Masto Announces Sentencing of Williams, a Las Vegas Behavior Health Worker
Las Vegas, NV - Nevada Attorney General Catherine Cortez Masto announced that Sherice Joann Williams, 39, of Las Vegas, was sentenced today in a Medicaid fraud case involving the submitting of false Medicaid claims.
November 4, 2013; Connecticut State Attorney's Office: Plainville Woman Charged with Scheming to Defraud Medicaid
A Plainville woman was arrested today and charged with scheming with the personal health care assistant paid with tax dollars to assist her to bill the government for twice as much time as the man actually worked. Steveann E. Daesener, age 40, of West Main Street, Plainville, was charged with one count each of Larceny in the First Degree By Defrauding A Public Community, Conspiracy to Commit Larceny in the First Degree and Insurance Fraud.
November 4, 2013; New York Attorney General: A.G. Schneiderman Announces Arrest of Doctor for Writing Prescriptions In Exchange For Cash and Sexually Explicit Photos
PLATTSBURGH - Attorney General Eric T. Schneiderman today announced the arrest of Dale T. Dudley, who is accused of mailing illegal prescriptions for the controlled substance Xanax to a former female patient in exchange for money and sexually explicit photos. Dudley was charged with two felony counts for selling prescriptions.
November 1, 2013; Tennessee Department of Finance & Administration: Jackson Co. Woman Charged 2nd Time With TennCare Fraud
NASHVILLE, TN - A Jackson County woman is charged with TennCare fraud for using the state's Medicaid program to obtain prescription drugs which she later apparently sold or gave away. This is her second time to face this charge. The Office of Inspector General, with the assistance of the Gainesboro Police, today announced the arrest of Ashley R. Robbins, 24, of Gainesboro.
November 1, 2013; Tennessee Department of Finance & Administration: Carroll Co. Woman Sentenced To Prison For TennCare Fraud
NASHVILLE, TN - A Carroll County woman charged with TennCare fraud has been sentenced to state prison after pleading guilty to the charge. The Office of Inspector General today announced the conviction of Jaime Denise Walker, 35, of Trezevant. She pleaded guilty to TennCare fraud and sale of a controlled substance.

October 2013

October 31, 2013; North Carolina Attorney General: Raleigh woman pleads guilty to defrauding Medicaid of nearly $500,000
A Raleigh woman who ripped off North Carolina's Medicaid program will now serve time behind bars and have to repay nearly $500,000, Attorney General Roy Cooper announced Wednesday. On Monday, Gloria J. Sawyer, aged 54, of Raleigh pleaded guilty to five felony counts of Obtaining Property by False Pretenses for defrauding the Medicaid program of at least $483,791.47 through false billings by her business, I Believe in Miracles. Wake County Superior Court Judge Donald W. Stephens sentenced her to a 16-20 month active prison sentence and ordered her to repay the money to the Medicaid program from her work release earnings.
October 31, 2013; Maryland Attorney General: Baltimore County Caregiver Convicted of Abuse of a Vulnerable Adult
Baltimore, MD - Attorney General Douglas F. Gansler announced today that Raphael N. Asinyang, 43, of Randallstown, pleaded guilty in the Circuit Court for Baltimore County to Abuse of a Vulnerable Adult in the Second Degree.
October 30, 2013; Massachusetts Attorney General: Owner of In-Home Care Business Sentenced to Jail, Company to Pay $3.3 Million for Billing MassHealth for Services not Provided
WOBURN - The owner of an in-home care company for elderly and disabled individuals pleaded guilty and was sentenced to two-and-a-half years in jail in connection with billing the state's Medicaid program for services that were not provided, Attorney General Martha Coakley announced today. During a hearing today in Middlesex Superior Court, Adlife Healthcare, LLC (Adlife) was ordered to pay $3.3 million in restitution.
October 30, 2013; Montana Attorney General: Attorney General Fox Announces Medicaid Fraud Case Successfully Prosecuted
Attorney General Tim Fox announced that a Missoula couple who recently pleaded guilty to defrauding Montana's Medicaid program will pay more than $22,000 in restitution.
October 30, 2013; Mississippi Attorney General: Booneville Couple Arrested for False Pretense and Embezzlement
A Prentiss County husband and wife have been indicted and arrested on charges of false pretense and embezzlement, announced Attorney General Jim Hood today. Dirley Jones, age 63, and Rita Jones, age 62, of Booneville turned themselves in to authorities in Prentiss County today. The arrests followed recent indictment by the Prentiss County Grand Jury on three counts felony false pretense and one count felony embezzlement. The indictment alleges that the Joneses, as owners and operators of Scott Del Cottage Assisted Living in Booneville, were receiving Medicaid payments for 19 residents, but then concealing those payments and continuing to collect monthly charges from the residents.
October 30, 2013; Tennessee Department of Finance & Administration: Hawkins Co. Man Charged With TennCare Doctor Shopping
Nashville, TN - A Hawkins County man is charged with TennCare doctor shopping in nearby Hamblen County, in an effort to obtain prescriptions for controlled substances. The Office of Inspector General today announced the arrest of Brandon Trent, 25, of Rogersville. He is charged with visiting multiple physicians within a short period to obtain controlled substances, using the state's Medicaid healthcare insurance program as payment.
October 29, 2013; Wisconsin Attorney General: Milwaukee Man Bound Over for Trial on Charges of Medicaid Fraud and Forgery
MADISON - Attorney General J.B. Van Hollen announced that a Milwaukee man facing charges related to a scheme to defraud the Wisconsin Medicaid Program involving false claims for funeral expenses was bound over for trial in Milwaukee County today before the Honorable Rosa M. Barillas. Douglas L. Patton has been charged with one count of Medicaid fraud, one count of forgery as a party to the crime, one count of engaging in the business of a funeral director without having a licensed funeral director in charge, one count of theft by fraud, and one count of theft.
October 29, 2013; Nevada Attorney General: Attorney General Masto Announces Sentencing of Husband and Wife Involved with Group Home
Las Vegas, NV - Nevada Attorney General Catherine Cortez Masto announced today the sentencing of a husband and wife involved with a group home facility in Las Vegas.
October 29, 2013; Tennessee Department of Finance & Administration: Sullivan Co. Woman Charged With TennCare Fraud
NASHVILLE, TN - A Sullivan County woman is charged with TennCare fraud in connection with using the state's healthcare insurance program to pay for fraudulent prescriptions for painkillers. The Office of Inspector General, with assistance from Kingsport Police, today announced the arrest of Amber Price, 23, of Kingsport.
October 28, 2013; Arkansas Attorney General: Attorney General Announces Two Arrests
LITTLE ROCK - Attorney General Dustin McDaniel announced today that health-care workers in Baxter County and Crittenden County were arrested last week following separate investigations by the Attorney General's Medicaid Fraud Control Unit.
October 25, 2013; Mississippi Attorney General: New Albany Nurse Charged with Illegally Obtaining Patient's Drugs
A Tippah County nurse is facing charges for illegally obtaining a controlled substance, announced Attorney General Jim Hood today. Renee Arleen Frain, age 30, of New Albany, turned herself in to investigators with the Attorney General's Medicaid Fraud Control Unit and the Tippah County Sheriff's Office today following indictment by the Tippah County Grand Jury on one count of obtaining a controlled substance by means of fraud, misrepresentation, or subterfuge.
October 28, 2013; Tennessee Department of Finance & Administration: Trousdale Co. Woman Is 2,000th TennCare Fraud Arrest
NASHVILLE, TN - A Trousdale County woman is charged with TennCare fraud and theft of services after she received healthcare insurance benefits through state's Medicaid program, even though she was not eligible. With the Trousdale County Sheriff's Department, the Office of Inspector General today announced the arrest of Danna Ann Hawkins, 50, of Hartsville. The arrest brings the total number of people arrested for TennCare fraud to 2,000 since the Office of Inspector General began investigating and pursuing this criminal activity.
October 28, 2013; Tennessee Department of Finance & Administration: Jackson County Woman Charged With TennCare Drug Fraud
NASHVILLE, TN - A Jackson County woman is charged in nearby Smith County with TennCare fraud for using the state's Medicaid program to obtain prescription drugs, and later distributing the drugs to others. The Office of Inspector General with the assistance of the Smith County Sheriff's Office today announced the arrest of Ashley R. Robins, 24, of Gainesboro. Robins is charged in an indictment with one count of TennCare fraud.
October 25, 2013; Kentucky Attorney General: Attorney General Conway Announces Arrest of Caretaker for Patient Neglect
Attorney General Jack Conway today announced the arrest of a caretaker in south central Kentucky for wanton neglect of an adult. 24-year-old Danielle West, of Science Hill, Ky., was arrested at her home Friday morning by investigators from General Conway's Department of Criminal Investigations acting on a warrant obtained by the OAG Medicaid Fraud and Abuse Control Division.
October 25, 2013; Tennessee Department of Finance & Administration: Jefferson Co. Woman Charged With TennCare Doctor Shopping
NASHVILLE, TN - A Jefferson County woman is charged in nearby Hamblen County with TennCare fraud involving doctor shopping, a crime involving a person using TennCare healthcare insurance benefits to go to multiple doctors to obtain controlled substances. The Office of Inspector General, with assistance from officers with the White Pine Police Department and Hamblen Sheriff's Office, today announced the arrest of Angela D. Burns, 41, of White Pine.
October 24, 2013; New York Attorney General: A.G. Schneiderman Announces Sentencing and $300k Settlement In The Case Of Michigan Man Who Fraudulently Obtained Medicaid Payments in New York
BELMONT - Attorney General Eric T. Schneiderman today announced the sentencing and a $300,000 settlement in the case of Fitzgerald A. Hudson, who illegally billed Medicaid for physician's services after obtaining enrollment as a Medicaid provider by using a fraudulently obtained New York medical license.
October 24, 2013; Louisiana Attorney General: Kenner Doctor Pleads Guilty To 35 Counts of Medicaid Fraud
A Kenner doctor pleaded guilty today to 35 counts of Medicaid fraud for running a scheme out of his medical practice aimed at defrauding the state's Medicaid program. Dr. Fiaz Afzal, 49, owner and internist at Claiborne Medical Corporation of 1000 Veterans Boulevard, was indicted in November 2010 by an East Baton Rouge Parish grand jury after an investigation revealed that Afzal submitted fraudulent claims regarding patient care to the Medicaid program for the purpose of obtaining greater compensation.
October 24, 2013; Tennessee Department of Finance & Administration: Hickman Co. Woman Charged With TennCare Drug Fraud
NASHVILLE, TN - A Hickman County woman is charged in Dickson County with TennCare fraud for using the state healthcare insurance program to pay for fraudulent prescriptions. The Office of Inspector General, with the assistance of the 23rd Judicial District Drug Task Force, today announced the arrest of Keaton Victoria Staggs, 22, of Centerville.
October 23, 2013; Louisiana Attorney General: Three Women Arrested In Medicaid Fraud Scheme
Three members of a Kenner personal care agency have been arrested for defrauding the state's Medicaid program, announced the Louisiana Attorney General's Medicaid Fraud Control Unit.
October 21, 2013; Delaware Attorney General: Biden's Office Secures Conviction of Healthcare Professional Charged with Patient Abuse
Georgetown - Attorney General Beau Biden announced today that his office has secured the conviction of a Sussex County woman who was charged with abusing an elderly patient at a Seaford nursing home.
October 21, 2013; Mississippi Attorney General: Meridian Caregiver Indicted for Exploitation of Vulnerable Person
A Meridian resident is facing charges of exploitation of a vulnerable person, announced Attorney General Jim Hood today. Cedric Blanchard, 28, of Meridian turned himself in to investigators with the Attorney General's Medicaid Fraud Control Unit today following recent indictment by the Lauderdale County Grand Jury for one count of exploitation of a vulnerable person.
October 21, 2013; Tennessee Department of Finance & Administration: Hamilton Co. Woman Charged With TennCare Doctor Shopping
Nashville, TN - A Hamilton County woman is charged with TennCare fraud involving doctor shopping - using TennCare healthcare insurance benefits to go to multiple doctors to obtain prescriptions for a controlled substance. The Office of Inspector General with assistance from the Hamilton County Sheriff, today announced the arrest of Joanna E. Killingsworth, also known as Joanna E. McGee, 29, of Chattanooga.
October 21, 2013; Tennessee Department of Finance & Administration: Two Giles Co. Residents Charged With TennCare Drug Fraud
Nashville, TN - Two people in Giles County are charged in separate cases with TennCare fraud involving selling prescription drugs paid for by the state's Medicaid healthcare insurance program. The Office of Inspector General announced the arrest of Christina J. Marks, 24, of Goodspring and Melanie B. Reach, 43, of Pulaski after a joint investigation with the Giles County Sheriff's Office and the Pulaski Police Department.
October 18, 2013; Minnesota Attorney General: Attorney General Swanson Asks Federal Agency to Investigate Complaints against Humana by Medicare Patients
Minnesota Attorney General Lori Swanson today asked the federal agency responsible for regulating private Medicare insurance policies to investigate and remedy complaints by Minnesota senior citizens about improper claims handling by Humana, which sells private Medicare policies in Minnesota.
October 18, 2013; Missouri Attorney General: Attorney General Koster announces guilty plea in Greene County Medicaid fraud case
Jefferson City, Mo. - Missouri Attorney General Chris Koster today announced that Angela Deanne Adams, of Greene County, pled guilty on October 4, 2013 in the Circuit Court of Greene County to four counts of Medicaid fraud. Adams was ordered to complete five years of supervised probation and to pay restitution totaling $3,342.27, plus court costs and fees.
October 18, 2013; Texas Attorney General: Former Co-Owner of RGV DME Biller Sentenced to Federal Prison for Health Care Fraud Scheme
McALLEN - The co-owner of a now defunct McAllen area durable medical equipment (DME) business and a former medical biller have been ordered to prison for their roles in a conspiracy and scheme to defraud Medicare and Medicaid through fraudulent billings, United States Attorney Kenneth Magidson and Texas Attorney General Greg Abbott announced today.
October 18, 2013; Virginia Attorney General: Cuccinelli Announces $37 Million Virginia Medicaid Fraud Settlement with McKesson Corp. For Inflating Prices of 400+ Drugs
RICHMOND - Attorney General Ken Cuccinelli announced today that Virginia will receive $37 million as part of a settlement his office negotiated with McKesson Corporation, one of the largest pharmaceutical wholesalers in the country, over allegations the company violated the Virginia Fraud Against Taxpayers Act by conspiring to inflate prices for more than 400 brand-named prescription drugs.
October 18, 2013; Mississippi Attorney General: Greenville Resident Arrested for Jury Tampering
A Greenville resident has been arrested and charged with jury tampering, announced Attorney General Jim Hood today. Marguerite Wilson, 31, of Greenville was arrested Tuesday by an investigator with the Attorney General's Medicaid Fraud Control Unit, with the assistance of a deputy with the Washington County Sheriff's Department.
October 17, 2013; Florida Attorney General: Miami-Dade Nursing Home Owner Arrested for $395,000 in Medicaid Fraud
Tallahassee, Fla.-Miami-Dade nursing home owner Julius Ast was arrested today by the Attorney General's Medicaid Fraud Control Unit and the Miami-Dade Police Department for allegedly using the billing names of four non-existent businesses to submit fraudulent invoices to his business, Pines Nursing Home, which were then paid with Medicaid funds. This fraudulent scheme ultimately resulted in more than $395,000 in payments to Julius Ast. He is charged with one count of Medicaid fraud, one count of grand theft, and one count of organized fraud, all first-degree felonies.
October 17, 2013; Alaska Attorney General: Anchorage Based Personal Care Attendant Charged for Fraudulently Billing Medicaid $94,339 over 29 Months
On October 17, 2013, the Medicaid Fraud Control Unit (MFCU) in the Alaska Department of Law announced the filing of criminal charges against personal care attendant (PCA) Barbara J. Kanehailua, age 60. The charges filed against Kanehailua are the result of an ongoing state and federal investigation into medical assistance fraud by employees of Good Faith Services, LLC (Good Faith), PCAs and Medicaid recipients receiving services from Good Faith.
October 17, 2013; Alaska Attorney General: Medicaid Recipient Convicted for Scheme to Fraudulently Bill Medicaid
On October 17, 2013, 53 year old Elisaia Siluano of Anchorage was sentenced by the Anchorage District Court on a single count of committing Medical Assistance Fraud. Siluano was sentenced to 180 days of suspended jail, a fine of $2,500, community work service of 80 hours which will convert to jail if not completed and informal probation for a period of five years. Siluano is prohibited from working as a personal care attendant for a period of five years and will be barred from billing Medicaid for a period of ten years following his discharge from probation. Siluano was also ordered to repay the State of Alaska $11,834.90.
October 17, 2013; Ohio Attorney General: Two Zanesville Men Sentenced to Prison in Coshocton Pharmacy Healthcare Fraud Case
AKRON, Ohio - Ohio Attorney General Mike DeWine announced today that two former associates of a Coshocton pharmacist have been sentenced to prison in a health care fraud scheme alleged to have taken between $1 million and $2.5 million from state, federal, and private medical insurance companies through fraudulent billing practices. The defendants were sentenced yesterday in United States District Court in Akron.
October 17, 2013; Tennessee Department of Finance & Administration: Four People In Humphries Co. Charged With TennCare Drug Fraud
NASHVILLE, TN - Four people are charged with TennCare fraud in Humphreys County after an investigation that netted a total of seven individuals arrested on indictments involving prescription drugs. The Office of Inspector General today announced the arrests, which are the result of an investigation also involving McEwen and Waverly Police.
October 17, 2013; Tennessee Department of Finance & Administration: Three Rutherford Co. Residents Charged With TennCare Fraud
NASHVILLE, TN - Three people in Rutherford County are charged with TennCare fraud for using the state's healthcare insurance program to pay for fraudulent prescriptions. The Office of Inspector General with the assistance of Smyrna Police today announced the arrests.
October 16, 2013; Nevada Attorney General: Attorney General Masto Announces Sentencing of Medical Equipment Company Manager for Medicaid Fraud
Carson City, NV - Nevada Attorney General Catherine Cortez Masto announced that Isidora DeGuzman, 53, of Las Vegas, was sentenced today for the gross misdemeanor offense of intentional failure to maintain adequate records for a fraud scheme involving submission of billing to Medicaid for different types or quantities of items than were actually delivered to Medicaid recipients.
October 15, 2013; Texas Attorney General: Attorney General Abbott Recovers More Than $10 Million for Texas as Fougera Pharmaceuticals Resolves Civil Medicaid Fraud Drug Pricing Investigation
AUSTIN - Texas Attorney General Greg Abbott today announced the resolution of a civil Medicaid fraud investigation that returns more than $10 million to the State of Texas. Following a lengthy investigation, the Office of the Attorney General determined that Fougera Pharmaceuticals Inc. fraudulently reported inflated drug prices to the Medicaid program.
October 10, 2013; Tennessee Department of Finance & Administration: Overton Co. Man Convicted on TennCare Fraud Charges
NASHVILLE, TN - An Overton County man pleaded guilty to TennCare fraud in connection with filling almost a dozen forged prescriptions for the painkillers and other drugs.The Office of Inspector General (OIG) today announced the conviction of Gary Lynn Garrett, 49, of Tyler, Texas. He pleaded guilty to 11 counts of TennCare fraud for filling forged prescriptions for the painkiller Oxycontin, as well as Xanax, an anti-anxiety medication and Phenergan, a stomach medication often used with painkillers.
October 9, 2013; District of Columbia Attorney General: District Wins Protracted Litigation over Health Plan's Medicaid Claims, Saving the District over $10,000,000
WASHINGTON, D. C. - The Contract Appeals Board (CAB or the Board) has ruled completely in favor of the District in several appeals in which a contractor sought more than $10,000,000 in damages and interest from the District, Attorney General Irvin B. Nathan announced today.
October 8, 2013; Utah Medicaid Office of Inspector General: Utah Medicaid OIG Recovers $11.5 Million in Taxpayer Funds
It has been another productive year for the Office of the Inspector General (OIG), which released its fiscal year 2013 (FY 2013) annual report late last month. Taxpayers received a return on investment (ROI) of 468% in FY 2013 based on the $11.5 million collected for OIG only investigations. That ROI jumps to 1008% by including the additional $13.3 million in OIG collections of Medicaid Fraud Control Unit (MFCU) cases.
October 8, 2013; Massachusetts Attorney General: Owner of Medical Transportation Company Arraigned for Billing Taxpayers for Rides under Dead People's Names
BOSTON - The owner of a medical transportation company in Webster has been arraigned in connection with defrauding the state's Medicaid program of more than $470,000 by billing for services under the names of deceased individuals, and for other medical trips that were never provided, Attorney General Martha Coakley announced today.
October 8, 2013; Maryland Attorney General: AG Gansler: Florida Woman Pleads Guilty to Medicaid Fraud
Baltimore, MD - Attorney General Douglas F. Gansler announced today that Carol A. Dunstan, 58, of Fort Lauderdale, Florida, pleaded guilty in the Circuit Court for Baltimore County to one count of felony Medicaid Fraud for collecting payments for personal care services that she did not provide.
October 8, 2013; Tennessee Department of Finance & Administration: Sullivan Co. Woman Charged With TennCare Fraud
Nashville, TN - A Sullivan County woman is charged with TennCare fraud for fraudulently claiming she was pregnant in order to be eligible for TennCare healthcare insurance benefits. The Office of Inspector General, with assistance from Kingsport Police, today announced the arrest of Kristy Dawn Kindle, 37, of Kingsport.
October 8, 2013; Arkansas Attorney General: Former Nursing Home Worker Convicted For Theft of Pills
Little Rock - Attorney General Dustin McDaniel announced today that a Saline County man accused of stealing a nursing home resident's prescription painkillers has been convicted of obtaining drugs by fraud.
October 7, 2013; Nevada Attorney General: Attorney General Masto Announces Sentencing of Las Vegas Behavioral Health Worker
Las Vegas, NV - Nevada Attorney General Catherine Cortez Masto announced that Garren Morris, 43, of Las Vegas, was sentenced today in a Medicaid fraud case involving the failure to maintain adequate records to support Medicaid claims.
October 4, 2013; New Jersey Attorney General: Operators of Middlesex County Medical Supply Store Plead Guilty to Health Care Claims Fraud for Defrauding Medicaid Out of More than $150,000 through Fraudulent Billing Scheme
TRENTON - Acting Attorney General John J. Hoffman announced that the operators of a Middlesex County medical supply store have pleaded guilty for their roles in a scheme to defraud the New Jersey Medicaid program out of at least $150,000.
October 3, 2013; Florida Attorney General: Attorney General Bondi Announces Arrest of Levy County Woman for Aggravated Abuse, False Imprisonment, Neglect and Exploitation
Tallahassee, Fla. -Attorney General Pam Bondi's office today arrested a Levy County resident and charged her with neglect of a disabled adult, false imprisonment, aggravated abuse, and exploitation. Allegations against Priscilla Smith Johnson, owner of Johnson's Adult Family Care Home, include neglecting to provide a bed for residents of the home, failing to provide medical services for a resident's wounds, restraining a disabled adult with handcuffs, willfully abusing a disabled adult and causing wounds on her wrists and permanent disfigurement, and failing to pay two disabled adult residents their required monthly personal needs allowance. Johnson's bond was set at $205,000.
October 3, 2013; Virginia Attorney General: Hampton Mental Health Provider Defrauded Medicaid for Unnecessary Services to Children; State Reclaims $1.5 Million in Fraudulent Payments
Newport News - A Hampton mental health service provider pled guilty earlier this week to a charge of health care fraud for falsely claiming that 66 Medicaid-eligible children she provided mental health treatment to actually needed it. She exaggerated or wholly invented their need for treatment to deceive Medicaid into approving payment for her services.
October 3, 2013; Tennessee Department of Finance & Administration: Overton Co. Man Charged With TennCare Drug Fraud
Nashville, TN - An Overton County man is charged with TennCare fraud in an indictment relating to obtaining a controlled substance by fraud. The Office of Inspector General today announced the arrest of Phillip Cody Jackson, 19, of Livingston, after a joint investigation with the Livingston Police Department.
October 2, 2013; Kentucky Attorney General: State Worker, Welfare Recipient Indicted on Felony Fraud Charges
Attorney General Jack Conway announced today that a state employee and a welfare recipient have both been indicted by a Franklin County Grand Jury for assistance program fraud.
October 2, 2013; Tennessee Department of Finance & Administration: Sumner Co. Man Charged 3rd Time With TennCare Doctor Shopping
NASHVILLE, TN - A Sumner County man is charged with TennCare fraud involving doctor shopping, for the third time in less than three months. The Office of Inspector General today announced the arrest of 42-year old John P. Lamb. He is accused in an indictment with fraudulently obtaining a controlled substance by doctor shopping for the painkiller Hydrocodone, using TennCare to pay for the doctor's office visits or the prescriptions.
October 2, 2013; Tennessee Department of Finance & Administration: Sullivan Co. Woman Charged With TennCare Doctor Shopping
NASHVILLE, TN - A Sullivan County woman is charged with TennCare fraud involving doctor shopping, or using TennCare to go to multiple doctors to obtain controlled substances. She is also charged with sale and delivery of the drugs. The Office of Inspector General, with assistance from Kingsport Police, today announced the arrest of Marty A. Mullins, 34, of Kingsport.

September 2013

September 30, 2013; Kentucky Attorney General: Attorney General Conway Announces Key Rulings in Purdue Pharma Case
Attorney General Jack Conway today announced two key rulings handed down from Pike Circuit Court Judge Steven Combs in the Commonwealth's case against Purdue Pharma, et al. involving the alleged illegal marketing of its opioid pain reliever OxyContin.
September 30, 2013; Michigan Attorney General: Schuette Announces Felony Medicaid Fraud Charges Against Four Southeast Michigan Mental Healthcare Providers
LANSING - Attorney General Bill Schuette today announced felony charges against four licensed Southeast Michigan mental healthcare providers for their role in an elaborate Medicaid fraud scheme.
September 30, 2013; South Dakota Attorney General: Optometrist Settles Healthcare Case with South Dakota and United States
PIERRE, S.D - South Dakota Attorney General Marty Jackley, United States Attorney Brendan V. Johnson, and Gerald Roy, Special Agent in Charge, United States Health and Human Services, Office of Inspector General jointly announce that the State of South Dakota and the U.S. have reached a settlement with a Rapid City optometrist in a civil case involving health care overpayments.
September 30, 2013; Tennessee Department of Finance & Administration: Blount Co. Woman Charged With TennCare Drug Fraud
NASHVILLE, TN - A Blount County woman is charged with TennCare fraud in nearby Sevier County. The charges are in connection with using TennCare to pay for fraudulent prescriptions for controlled substances. The Office of Inspector General with assistance from the Sevierville Police Department today announced the arrest of Chastity Sexton, 37, of Seymour.
September 30, 2013; Tennessee Department of Finance & Administration: Sullivan Co. Woman Charged With TennCare Drug Fraud
NASHVILLE, TN - A Sullivan County woman is charged with selling prescription drugs obtained through benefits under the TennCare state healthcare insurance plan. The Office of Inspector General today announced the arrest of Amelia G. Dugger, 47, of Kingsport.
September 30, 2013; Tennessee Department of Finance & Administration: Knox Co. Woman Charged With 15 Counts Of TennCare Fraud
NASHVILLE, TN - A Knox County woman is charged with TennCare fraud and theft of services after she received healthcare insurance benefits through the state program, even though she was not eligible. The Office of Inspector General today announced the arrest of Candice Shavon Flynn, also known as Shannon Chadwick or Candy Flynn, 34, of Knoxville. She is charged with 15 counts of TennCare fraud, and four counts of theft of services.
September 27, 2013; Ohio Attorney General: Ohio Attorney General, Bureau of Workers' Compensation Announce Chiropractor Fraud Convictions
Columbus, Ohio -- Ohio Attorney General Mike DeWine and Ohio Bureau of Workers' Compensation Administrator/CEO Steve Buehrer announced today that two Ohio chiropractors have been sentenced to pay nearly $179,000 in combined restitution to Medicaid and the Bureau of Workers' Compensation (BWC).
September 26, 2013; Maryland Attorney General: AG Gansler Announces Final Sentencing in Nursing Certifications Scheme
Baltimore, MD - Attorney General Douglas F. Gansler announced today that Natiakia Monique Sanders was sentenced for her role in a scheme to buy and sell fraudulent nursing assistant certifications issued by a former employee of the Maryland Board of Nursing.
September 25, 2013; Georgia Attorney General: Muscogee County Medicaid Provider Accused of Filing $269K in False Claims
On Tuesday, September 24, 2013, the Muscogee County Grand Jury returned an indictment against Della Upshaw for two counts of Medicaid Fraud (O.C.G.A. § 49-4-146.1(b)) for making false claims to Georgia Medicaid.
September 25, 2013; New York Medicaid Inspector General: UCP of Ulster County Overbilled Medicaid $2.27 million
United Cerebral Palsy (UCP) of Ulster County will repay New York State's Medicaid program $2.27 million, after two audits by the Office of the Medicaid Inspector General (OMIG) discovered overpayments resulting mainly from excessive levels of missing documentation. The audits reviewed UCP's day treatment program services. Under day treatment, persons with developmental disabilities receive a comprehensive array of coordinated services designed to promote and attain independence, inclusion, and productivity in the community.
September 24, 2013; Indiana Attorney General: Warrant Search Conducted At Clinic Locations, Offices Can Reopen
ANDERSON, Ind. - Today investigators conducted a warrant search at a medical practice with locations in Anderson and Elwood and collected records as part of an ongoing investigation into possible overprescribing of patients and possible Medicaid fraud.
September 24, 2013; Tennessee Department of Finance & Administration: Cocke Co. Woman Charged With TennCare Doctor Shopping
Nashville, TN - A Cocke County woman is charged in nearby Greene County with TennCare fraud involving doctor shopping, or using TennCare to go to multiple doctors to obtain controlled substances. The Office of Inspector General, with the assistance of the Greene County Sheriff's Office, today announced the arrest of Diamond Ahrens, 20, of Newport.
September 24, 2013; Tennessee Department of Finance & Administration: Rutherford Co. Woman Sentenced After Pleading Guilty To TennCare Fraud
Nashville, TN - A Rutherford County woman has been sentenced, after pleading guilty to TennCare fraud charges earlier this year. The Office of Inspector General today announced that Kristy Robinson, 26, of Smyrna, pleaded guilty to felony TennCare fraud and theft of services. Rutherford Criminal Circuit Court ordered her to make restitution to TennCare of over $12,000 as well as paying court costs. She is also banned from applying for or receiving TennCare benefits in the future. The court also sentenced her to five years in prison, but suspended the sentence to supervised probation.
September 23, 2013; Vermont Attorney General: Attorney General Settles with Twenty-Five Manufacturers over Violations of Vermont's Prescribed Product Gift Ban And Disclosure Law
Last week, the Attorney General's Office filed Assurances of Discontinuance executed by twenty-five manufacturers settling violations of Vermont's Prescribed Product Gift Ban and Disclosure Law. Each manufacturer agreed to prospective compliance with the law, which bans most gifts to Vermont health care providers and requires manufacturers of prescribed products-including pharmaceuticals, biologics and medical devices-to disclose expenditures deemed appropriate by the legislature.
September 23, 2013; New York Attorney General: A.G. Schneiderman Announces Guilty Plea By Owner Of Long Island Ambulette Company Who Stole Nearly $350k From Medicaid
MINEOLA - Attorney General Eric T. Schneiderman today announced that Patricia Clague, the owner of Angel Ambulette in Nassau County, pleaded guilty to felony grand larceny. She admitted that, under her direction, the company billed and was paid nearly $350,000 by the Medicaid program for transportation services that were never provided or were provided to Medicaid recipients by untrained and improperly licensed drivers. Under the terms of her plea deal, Clague will pay the state $348,000 in restitution and serve four months in prison, beginning October 1.
September 23, 2013; Tennessee Department of Finance & Administration: Williamson Co. Woman Charged With TennCare Drug Fraud And Murder
NASHVILLE, TN - A Williamson County woman is charged with TennCare fraud, relating to the reckless distribution of the painkiller Oxycodone, which apparently caused the death of another person. The drug was paid for using TennCare healthcare insurance benefits. The Office of Inspector General today announced the arrest of Frances Kay Lane, also known as Frances Mangrum. She is charged in an indictment with TennCare fraud, second degree murder, and reckless homicide.
September 20, 2013; Massachusetts Attorney General: Sandisfield Nurse Sentenced in Connection with Defrauding $25,000 From MassHealth While at Horseracing Competitions
PITTSFIELD - A nurse from Sandisfield has been sentenced in connection with a scheme to bill the state's Medicaid program more than $25,000 while at horse racing competitions, Attorney General Martha Coakley announced today.
September 20, 2013; Florida Attorney General: Cape Coral Resident Arrested for Alleged Medicaid Fraud
Florida Attorney General Pam Bondi announced today that her Medicaid Fraud Control Unit worked with the Hendry County Sheriff's Office to arrest Kim Dodson for allegedly submitting false claims to the Medicaid program and receiving payment for services that she never rendered.
September 19, 2013; Tennessee Department of Finance & Administration: Sumner Co. Man Charged With TennCare Doctor Shopping
NASHVILLE, TN - A Sumner County man is charged in an indictment with TennCare fraud involving doctor shopping, or using TennCare to go to multiple doctors to obtain controlled substances. The Office of Inspector General, with assistance from the Sumner County Sheriff's Office, today announced the arrest of James Jeffrey Bond, 29, of Gallatin.
September 18, 2013; Tennessee Department of Finance & Administration: Wilson County Woman Charged With TennCare Fraud
NASHVILLE, TN - A Wilson County woman is charged in an indictment with TennCare fraud for falsely reporting her income in order to appear eligible for the state's healthcare insurance program. The Office of Inspector General, with assistance from Wilson County Sheriff's Officers, today announced the arrest of Wanda June Williams, 53, of Mt. Juliet.
September 17, 2013; North Carolina Attorney General: Dentist pleads guilty to cheating Medicaid
Raleigh - A North Carolina dentist has pleaded guilty to charges related falsely billing Medicaid for dental and oral surgery services and will pay $114,000 in restitution.
September 16, 2013; Tennessee Department of Finance & Administration: Lawrence Co. Man Charged 2nd Time With TennCare Fraud
NASHVILLE, TN - A Lawrence County man is charged for a second time with TennCare fraud for obtaining medical treatment and using his son's TennCare benefits to pay for them. The Office of Inspector General along with the Maury County Sheriff's Office today announced the arrest of 33-year old David Wayne Byrd, Sr., of Westpoint.
September 13, 2013; Arkansas Attorney General: Three Arrested For Medicaid Fraud
LITTLE ROCK - Attorney General Dustin McDaniel announced today that a Medicaid beneficiary and two of his associates have been arrested for allegedly conspiring to defraud the Arkansas Medicaid Program of nearly $17,000. Robert Lee Miller, 47, and Robin Shuntell Morris, 25, both of Morrilton, and Tracey Denise Miller, 28, of West Memphis were each arrested for one count of felony Medicaid fraud following an investigation by the Attorney General's Medicaid Fraud Control Unit.
September 12, 2013; New York Attorney General: A.G. Schneiderman Announces Indictment Of Nurse Who Stole Pain Patches From Ventilator-dependant Nursing Home Residents
BRONX -- Attorney General Eric T. Schneiderman today announced the felony indictment of Pedrito L. Melecio, a former Registered Nurse at St. Barnabas Rehabilitation & Continuing Care Center, on grand larceny, among other charges, for stealing Fentanyl patches, a controlled substance used for pain management, from two ventilator-dependent residents. If convicted, he faces up to 4 years in prison. Melecio was fired as a result of this incident.
September 12, 2013; Tennessee Department of Finance & Administration: Davidson Co. Woman Charged With TennCare Drug Fraud
NASHVILLE, TN - A Davidson County woman is charged with TennCare fraud for filling a fraudulent prescription and using TennCare healthcare insurance benefits to pay for it. The Office of Inspector General today announced the arrest of Valerie Lynn Layne, 25, of Old Hickory. Metro Nashville Police assisted with this arrest.
September 12, 2013; Tennessee Department of Finance & Administration: Jefferson County Couple Charged With TennCare Doctor Shopping
NASHVILLE, TN - A husband and wife from Jefferson County are charged in nearby Claiborne County for doctor shopping, or going to multiple doctors to obtain controlled substances, and using public healthcare insurance benefits as payment through the TennCare program. The Office of Inspector General, with assistance from the Claiborne County Sheriff's Office, today announced the arrest of Barbara Hickey, 44, and William D. Hickey, 53, both of Jefferson City.
September 11, 2013; New York Office of Medicaid Inspector General: More Than $1 Million in Medicaid at Bronx and LI Nursing Homes
Three nursing homes will reimburse New York State a combined total of $1,069,348 because of overpayments because of overpayments disclosed in a series of audits conducted by the Office of Medicaid Inspector General. The facilities, located in the Bronx and Long Island, will repay the Medicaid program after having been cited for adding costs to the rates attached to the use of automobiles by administrators unrelated to providing medical care.
September 11, 2013; Tennessee Department of Finance & Administration: Knox Co. Woman Charged With TennCare Doctor Shopping
NASHVILLE, TN - A Knox County woman is charged in an indictment with TennCare fraud involving doctor shopping, or using TennCare to go to multiple doctors to obtain controlled substances. The Office of Inspector General, with assistance from the Knox County Sheriff's Office, today announced the arrest of Deloris McClure, 42, of Knoxville. She is charged with nine counts of fraudulently using TennCare to obtain controlled substances by doctor shopping. In addition, McClure was charged with 14 counts of obtaining a controlled substance by fraud.
September 11, 2013; Tennessee Department of Finance & Administration: Sumner County Woman Charged A 3rd Time With TennCare Doctor Shopping
NASHVILLE, TN - A Sumner County woman is charged for the third time with doctor shopping, or going to multiple doctors to obtain the same or similar controlled substances and using TennCare healthcare insurance benefits as payment. The Office of Inspector General, with assistance from Metro Nashville Police officers, today announced the arrest of 32-year old Katherine L. Fry. She is charged in an indictment with four counts of fraudulently obtaining a controlled substance by doctor shopping for the painkiller Oxycodone, using TennCare to access healthcare benefits.
September 11, 2013; Tennessee Department of Finance & Administration: Wilson Co. Man Charged 2nd Time With TennCare Doctor Shopping
NASHVILLE, TN - A Wilson County man is charged for a second time with doctor shopping for controlled substances, using TennCare benefits as payment. The Office of Inspector General today announced the arrest of 31-year old Christopher R. Bailey. Metro Nashville Police officers assisted in the arrest. In the latest charges, Bailey was indicted by the Davidson County Grand Jury on two counts of fraudulently obtaining a controlled substance by doctor shopping for drugs, using TennCare to access healthcare benefits.
September 10, 2013; Florida Attorney General: Attorney General Bondi's Office Arrests Suwannee County Woman for Exploitation of an Elderly Person
TALLAHASSEE, Fla.-Attorney General Pam Bondi today announced that a Suwannee County woman is in custody after being charged with one count of exploitation of an elderly person. Christin Dawn Henderson, of Live Oak, was arrested on a felony warrant by the Attorney General's Medicaid Fraud Control Unit. According to an investigation, Henderson, 31, stole money from a man over whom she had the power of attorney. This alleged theft resulted in the elderly adult becoming indebted to the health care facility that is providing him with full-time care, and it deprived him of his personal needs allowance of nearly $20,000.
September 9, 2013; Tennessee Department of Finance & Administration: Two Pickett Co. Residents Charged With TennCare Drug Fraud
Nashville, TN - Two Pickett County residents are charged in separate cases with TennCare fraud involving prescription drugs. The Office of Inspector General today announced the arrest of Michael J. Hall, 38, and William H. Pemberton, 66, both of Byrdstown. The arrests were assisted by the Pickett County Sheriff's Office. Each man is charged with using TennCare benefits to obtain the painkiller Oxycodone, a Schedule II controlled substance, while planning to distribute a portion of the prescription.
September 6, 2013; Massachusetts Attorney General: Worcester Pharmacy to Pay $1.6 Million Over Claims of Operating an Unauthorized Automatic Refill Program
BOSTON - A pharmacy based in Worcester has agreed to pay $1.6 million to settle allegations that it improperly billed and received payments from the state's Medicaid program when it automatically refilled prescription medications that were not specifically requested by MassHealth patients, Attorney General Martha Coakley announced today.
September 5, 2013; Maryland Attorney General: Nursing Home Aide Convicted for Abuse of a Vulnerable Adult
Baltimore, MD - Attorney General Douglas F. Gansler announced today that Donte L. Spriggs, of Baltimore, was convicted of Abuse of a Vulnerable Adult in the Second Degree in the Circuit Court for Baltimore City. Judge Stephen Sfekas accepted Spriggs' guilty plea and entered a disposition of probation before judgment. Spriggs was placed on two years' probation, during which time he is prohibited from being employed in any position that includes the supervision of vulnerable adults.
September 5, 2013; New York Office of Medicaid Inspector General: Bronx Rite Aid Overcharged Medicaid Nearly $200K
Albany, NY -- Irregularities in billings for prescriptions for Medicaid recipients discovered during an audit of Rite Aid Pharmacy location #3507, 650 East Tremont Street in the Bronx, led to projected overpayments of more than $193,275, according to the New York State Office of the Medicaid Inspector General.
September 5, 2013; Tennessee Department of Finance & Administration: Monroe Co. Man Charged 2nd Time With TennCare Doctor Shopping
Nashville, TN - A Monroe County man is charged for the second time with TennCare doctor shopping, a crime involving the pursuit of prescription drugs. The Office of Inspector General, with assistance from the Monroe and McMinn County Sheriff's Offices, today announced the arrest of Richard Martin, 32, of Sweetwater.
September 4, 2013; Georgia Attorney General: Owner of Speech Therapy Company Sentenced to Prison for Stealing Over $430K from Georgia
Medicaid
On Thursday, August 29, 2013, Erika Robinson, of Lithonia, Ga., pled guilty in Cobb County Superior Court to one felony count of Medicaid Fraud (O.G.G.A. § 49-4-146.1(b)) for fraudulently billing Georgia Medicaid. Judge Robert D. Leonard sentenced Robinson under the First Offender Act to two years in prison, followed by eight years probation and restitution in the amount of $438,622.03.
September 4, 2013; Attorney General of Texas: State of Texas, U.S. to Share in $5 Million Recovery of Medicaid Funds
AUSTIN - Texas Attorney General Greg Abbott today announced that the State of Texas and the federal government will equally share in a $5 million settlement with Major Pharmaceuticals Inc. to resolve civil Medicaid fraud claims. Also named in the settlement is co-defendant The Harvard Drug Group LLC.
September 4, 2013; Nevada Attorney General: Attorney General Masto Announces Former Group Home Manager Sentenced
Las Vegas, NV - Nevada Attorney General Catherine Cortez Masto announced today that a former manager of a group home facility in Las Vegas, who neglected one of the residents of that facility, has been sentenced to nine months in jail, suspended, ordered to complete 16 hours of community service each month during a two year probationary time period, and ordered to pay $6,000 in restitution, penalties, and costs.
September 4, 2013; Arkansas Attorney General: Perry County Women Accused of Taking Money from Nursing Home Residents
LITTLE ROCK - Attorney General Dustin McDaniel announced today that former employees of a Perry County nursing home have been arrested for multiple felony counts of exploitation for allegedly using residents' personal funds to buy clothing, jewelry, shoes and makeup for themselves.
September 4, 2013; Florida Office of the Attorney General: Attorney General Bondi's Office Arrests Hillsborough County Couple in Medicaid Fraud Scheme
TALLAHASSEE, Fla. -Attorney General Pam Bondi's Medicaid Fraud Control Unit today arrested Everett Ashby, 69, and Catherine Ashby, 64, for Medicaid fraud. The Medicaid Fraud Control Unit investigated the two for allegedly billing the Medicaid program for $13,000 for services that were never provided. The Ashbys operated an adult family care home from their residence in Tampa.

August 2013

August 30, 2013; Arkansas Attorney General: Marion County Woman Arrested For Medicaid Fraud
Little Rock - Attorney General Dustin McDaniel announced today that a Marion County health-care worker accused of billing the Arkansas Medicaid Program for services she did not provide has been arrested for felony Medicaid fraud. Amanda Coker, 35, of Yellville, was arrested Thursday.
August 29, 2013; Kings County, NY District Attorney: Owner Of A Williamsburg Pharmacy Indicted For Illegally Receiving Nearly $800,000 In Medicaid Payments
Brooklyn - Kings County District Attorney Charles J. Hynes, Human Resources Administration Commissioner Robert Doar, and U.S. Department of Health and Human Services, Special Agent in Charge, Thomas O'Donnell today announced the indictment of V&A Pharmacy, Inc. and its owner, Aleksandr Ilyayev, 41, for fraudulently collecting nearly $800,000 in Medicaid payments between January 19, 2011 and November 29, 2012.
August 29, 2013; Nevada Attorney General: Attorney General Masto Announces Sentencing of Las Vegas Personal Care Assistant
Las Vegas, NV - Nevada Attorney General Catherine Cortez Masto announced that Niurvis Rodriguez, 36, of Las Vegas, was sentenced today in a Medicaid fraud case involving the submission of false Medicaid claims.
August 29, 2013; Tennessee Department of Finance & Administration: Davidson Co. Woman Charged With TennCare Doctor Shopping
Nashville, TN - A Davidson County woman is charged with TennCare fraud involving doctor shopping, which is the crime of using TennCare state healthcare insurance benefits to go to multiple doctors to obtain prescriptions for controlled substances. The Office of Inspector General with the assistance of the Metro Nashville Police Department today announced the arrest of Griselda Castaneda-Camacho, 29, of Nashville.
August 28, 2013; Louisiana Attorney General: Folsom Family Arrested for Medicaid Fraud, Racketeering, and Cruelty
Today Attorney General Buddy Caldwell said a criminal investigation by the Attorney General's Medicaid Fraud Control Unit has unraveled a Folsom family's alleged pattern of Medicaid fraud, criminal conspiracy and financial exploitation arising from more than $400,000 in Medicaid-funded care paid on behalf of a disabled relative. Three family members face a combined 24 felony charges, including racketeering, criminal conspiracies to commit Medicaid fraud and filing false public records, Medicaid fraud, filing false public records, theft by fraud, forgery and money laundering in connection with a scheme to bill Louisiana's Medicaid program for services not actually rendered.
August 28, 2013; Tennessee Department of Finance & Administration: Dickson Co. Woman Charged With TennCare Drug Fraud
Nashville, TN - A Dickson County woman is charged with TennCare fraud for selling prescription drugs that were paid for by the state's healthcare insurance program. The Office of Inspector General today announced the arrest of Mona Darlene Ramey, 56, of Dickson, after a joint investigation with the Dickson County Sheriff's Office.
August 26, 2013; Tennessee Department of Finance & Administration: Monroe Co. Man Charged With Doctor Shopping For Drugs
Nashville, TN - A Monroe County is charged with TennCare doctor shopping, which is using TennCare to go to multiple healthcare providers in a short time period to obtain controlled substances. The Office of Inspector General, with the assistance of the Monroe County Sheriff's Office, today announced the arrest of Richard Martin, 31, of Sweetwater, Tennessee. He is charged with one count of fraudulently using TennCare to obtain controlled substances by "doctor shopping," for controlled substances, with the physician office visits or the prescriptions being paid for with TennCare benefits.
August 26, 2013; Tennessee Department of Finance & Administration: TennCare Doctor Shopping Arrest In Knox County
Nashville, TN - After being on the run for the past four months, a Sevier County man is under indictment in Knox County for TennCare fraud involving "doctor shopping," or using TennCare to go to multiple doctors in a short time period to obtain controlled substances. The Office of Inspector General, with the assistance of the Sevier and Knox County Sheriff's Offices, today announced the arrest of Clark Michael Shelton, 36, of Kodak, Tennessee.
August 26, 2013; Tennessee Department of Finance & Administration: Bedford County Woman Charged With TennCare Fraud
Nashville, TN - A Bedford County woman is charged with TennCare fraud. The Office of Inspector General, with the assistance of officers from the Bedford County Sheriff and Smyrna Police, today announced the arrest of Heather Dawn Deskins, 29, of Shelbyville. She is charged in a Bedford County indictment with two counts of TennCare fraud for fraudulently obtaining TennCare healthcare insurance benefits on two separate occasions, even though she was not eligible for the program.
August 26, 2013; Connecticut State Attorney's Office: Former Nursing Home Clerk Sent to Prison for Stealing Patient Funds
A former accounts receivable clerk at a Waterbury nursing home was sentenced today to serve seven years in prison for stealing from a trust account that held money belonging to the home's patients.
August 23, 2013; Georgia Attorney General: Owner of Henry County Personal Care Home Sentenced to Prison for Falsely Claiming to be Registered Nurse
On August 19, 2013, Madeline Laruy entered a non-negotiated guilty plea to one count of Medicaid Fraud and one count of False Statements and Writings in Henry County Superior Court. Judge Wade Crumbley sentenced Laruy to 180 days in prison, followed by four and a half years probation. Laruy was also ordered to pay $61,346.07 in restitution for Georgia Medicaid payments fraudulently obtained between May 1, 2009 and April 23, 2012.
August 22, 2013; Florida Attorney General: Miami-Dade Pharmacy Owner Arrested for Nearly $600,000 in Medicaid Fraud
TALLAHASSEE, Fla.-An investigation by Attorney General Pam Bondi's Medicaid Fraud Control Unit uncovering nearly $600,000 of Medicaid fraud concluded today with the arrest of Coralia Perez. According to the investigation, Perez, owner of Patient's Pharmacy & Infusion in Hialeah, submitted fraudulent invoices to the Agency for Health Care Administration to make it appear that the pharmacy had dispensed the correct amount of medications for which they had billed the Medicaid program.
August 22, 2013; Tennessee Department of Finance & Administration: Cheatham Co. Woman Charged With TennCare Fraud
Nashville, TN - A Cheatham County woman is charged with TennCare fraud in nearby Davidson County. The Office of Inspector General with assistance from Metro Nashville Police, today announced the arrest of Betty M. Joslin, 37, of Kingston Springs.
August 22, 2013; Tennessee Department of Finance & Administration: Verton Co. Man Charged With TennCare Drug Fraud
Nashville, TN - An Overton County man is charged with TennCare fraud for diverting prescription drugs that were paid for with public healthcare insurance benefits through the state's TennCare program. The Office of Inspector General today announced the arrest of Roger Bilbrey, 52, of Rickman, Tennessee, after a joint investigation with the Livingston Police Department.
August 21, 2013; Tennessee Department of Finance & Administration: Wilson Co. Man Charged With Doctor Shopping For Drugs
NASHVILLE, TN - A Wilson County is indicted for TennCare fraud involving doctor shopping, which involves going to multiple doctors in a short period of time to get prescription drugs, using TennCare as payment. The Office of Inspector General with the assistance of the Wilson County Sheriff's Office today announced the arrest of Christopher R. Bailey, 31, of Lebanon.
August 16, 2013; Wisconsin Attorney General: Milwaukee Man Charged with Medicaid Fraud, Forgery, Theft and Engaging in the Business of a Funeral Director Without a Funeral Director in Charge
MADISON - Attorney General J.B. Van Hollen announced that a Milwaukee man faces charges related to a scheme to defraud the Wisconsin Medicaid Program involving false claims for funeral expenses. Douglas L. Patton has been charged with one count of Medicaid fraud, one count of forgery as a party to the crime, one count of engaging in the business of a funeral director without having a licensed funeral director in charge, one count of theft by fraud, and one count of theft.
August 16, 2013; Massachusetts Attorney General: New Bedford Doctor Pleads Guilty to Charges of Prescribing Oxycodone Illegally to Patients
FALL RIVER - A New Bedford physician pleaded guilty to charges of illegally prescribing drugs to 15 of his patients and defrauding the state's Medicaid program, Attorney General Martha Coakley announced today.
August 14, 2013; Georgia Attorney General: Gainesville Man Pleads Guilty to Medicaid Fraud
On August 13, 2013, David Brannon, of Gainesville, Ga., pled guilty to one count of Medicaid Fraud (O.C.G.A. § 49-4-146.1(b)) in Hall County Superior Court. Brannon was paid almost $150,000 by Georgia Medicaid as a result of fraudulent billing.
August 14, 2013; New York Attorney General: A.G. Schneiderman Announces Guilty Plea Of Former Disabled Services Employee For
Fraudulent Billing
Webster -- Attorney General Eric T. Schneiderman today announced that Akin Ross, a former Medicaid service coordinator at Continuing Developmental Services Monarch, pled guilty to causing $24,798.75 in fraudulent billings to the New York State Medicaid program after using a phony college diploma to obtain his job.
August 13, 2013; Georgia Attorney General: Pair Already Facing Medicaid Fraud Charges Accused of Income Tax Evasion
On Friday, August 9, 2013, a Fulton County Grand Jury indicted Derrell Jackson and Shayla Darrington-Jackson for two counts of Income Tax Evasion (O.C.G.A. � 48-7-5). The Jacksons are also facing charges in Gwinnett County for Medicaid Fraud for allegedly obtaining over $600,000 of Medicaid funds by submitting false billing to the Georgia Medicaid program over the course of three years.
August 13, 2013; Nevada Attorney General: Attorney General Masto Announces Sentencing Of Las Vegas Group Home Operator
Las Vegas, NV - Nevada Attorney General Catherine Cortez Masto announced that Luzviminda Rosario Jose, 50, of Las Vegas, was sentenced today for operating a residential facility without a license.
August 13, 2013; Louisiana Attorney General: AG Caldwell Recovers $8.5 Million During Fraud Trial of Drug Company
Today Watson Pharmaceuticals Inc. agreed to pay Louisiana $8.5 Million to resolve the fraudulent drug pricing claims against them. The agreement was announced in the 19th Judicial District Court before Judge Wilson Fields, just as Louisiana was about to give its opening statement to the jury panel of twelve men and women.
August 13, 2013; Tennessee Department of Finance & Administration: Sullivan County Woman Charged With TennCare Drug Fraud
Nashville, TN - A Sullivan County woman is charged with TennCare fraud for using the program to obtain prescription drugs, which she's accused of subsequently selling. The Office of Inspector General assisted the Bristol Police Department in the arrest of Deborah L. Arnold, 56, of Bristol.
August 9, 2013; Tennessee Department of Finance & Administration: Cheatham County Man Charged With TennCare Drug Fraud
Nashville, TN - A Cheatham County man is charged with TennCare fraud for using the taxpayer-funded healthcare insurance program to pay for a fraudulent prescription for a painkiller. The Office of Inspector General, with the assistance of the Ashland City Police Department and the Cheatham County Sheriff's Office, today announced the arrest of Daniel Lee Pritchett, 25, of Ashland City.
August 8, 2013; Michigan Attorney General: Schuette Charges West Michigan Physician's Assistant for Over-Prescribing Drugs, Medicaid Fraud
LANSING - Attorney General Bill Schuette today announced the filing of charges against David Hammond-Koskey, 59, of Ludington for his alleged role in submitting multiple fraudulent Medicaid billings as a licensed physician's assistant.
August 7, 2013; Nevada Attorney General: Attorney General Masto Announces Sentencing of Two California Women for Medicaid Fraud at Washoe Valley Behavioral Health Provider Defendants Double Billed for Equine Facilitated Therapy
Reno, NV - Nevada Attorney General Catherine Cortez Masto today announced that Suzanne Pindell, 64, of Fork of Salmon, California, and Terra Shepherd, 44, of Chico, California, and the behavioral health company they owned, HealTherapy of Nevada, were each sentenced today for a misdemeanor offense of submission of false Medicaid claims for a scam that double billed for equine facilitated therapy.
August 7, 2013; New York Attorney General: A.G. Schneiderman Announces Prison Sentence In Medicaid Thefts Of $10 Million By Five NYC Pharmacies
NEW YORK - Attorney General Eric T. Schneiderman today announced the sentencing of Sanjay K. Patel, the former owner of three Bronx and one Manhattan pharmacy, for stealing $7.7 million from New York State's Medicaid Program.Patel was sentenced in State Supreme Court in the Bronx to a prison term of 1 to 3 years. He was arrested by special investigators from the Attorney General's Medicaid Fraud Control Unit (MFCU) last fall after a wide-ranging investigation uncovered over $10 million in fraud at several New York City pharmacies. The investigation ended with the arrest and convictions of five individuals, four of whom were licensed pharmacists in New York, and seven corporations. Since December, all of the defendants arrested as part of the investigation have admitted to stealing from Medicaid.
August 6, 2013; New York Medicaid Office of Inspector General: OMIG Investigation Leads to Indictment
Kristina Zelinsky was indicted on August 6, 2013 in Brooklyn by Kings County District Attorney Charles J. Hynes for fraudulently collecting more than $25,000 in Medicaid benefits since 2003. The action was the result of a collaboration between the DA's Office, OMIG, and the New York City Human Resources Administration.
August 5, 2013; New Hampshire Attorney General: Robert Seung-Bok Lee
Attorney General Joseph A. Foster announces that Robert Seung-Bok Lee of Baltimore, Maryland was convicted and sentenced on August 5, 2013, for one count of theft by deception. Lee, a Medicaid recipient, pled guilty in Merrimack County Superior Court to one count of a class A felony theft by deception charge. Beginning in 2003 and continuing through September of 2011, Lee submitted hundreds of fraudulent timecards to Granite State Independent Living that falsely represented that he was receiving personal care attendant services from a careworker. Over the course of eight years, GSIL paid over $150,000 in wages for services that were not rendered.
August 5, 2013; Tennessee Department of Finance & Administration: Sullivan County Woman Charged With TennCare Fraud
Nashville, TN - A Sullivan County woman is charged with TennCare fraud and theft of services after she received healthcare insurance benefits through TennCare, even though she was not eligible for the program. The Office of Inspector General today announced the arrest of Michelle Davis, 35, of Bristol.
August 5, 2013; Tennessee Department of Finance & Administration: Maury County Woman Charged With TennCare Drug Fraud
Nashville, TN - A Maury County woman is charged with TennCare fraud in Marshall County in connection with the illegal distribution of prescription drugs paid which had been paid for using TennCare benefits. The Office of Inspector General today announced the arrest of Jennifer Rose White Dawes, 21, of Culleoka, after a joint investigation with the Giles and Marshall County Sheriffs' Offices.
August 5, 2013; Tennessee Department of Finance & Administration: Giles County Man Charged 2nd Time With TennCare Doctor Shopping
Nashville, TN - A Giles County man is charged in Marshall County with TennCare fraud involving doctor shopping for drugs, using TennCare as payment. The Office of Inspector General today announced the arrest of Joseph Eugene Bowen, 25, of Lynnville.
August 1, 2013; New York Attorney General: A.G. Schneiderman Announces Guilty Plea And $300k Settlement In The Case Of Michigan Man Who Fraudulently Obtained Medicaid Payments In New York
Belmont - Attorney General Eric T. Schneiderman today announced that his office has secured a felony guilty plea and $300,000 settlement from Fitzgerald A. Hudson, who billed Medicaid for physician's services after obtaining enrollment as a Medicaid provider under false pretenses. Hudson, whose fraudulently-obtained New York medical license was revoked in 2010, was indicted in Allegany County on grand larceny and other criminal charges last summer.
August 2, 2013; Tennessee Department of Finance & Administration: Giles Co. Man Charged With TennCare Drug Fraud
NASHVILLE, TN -A Giles County man is charged with TennCare fraud for selling prescription drugs paid for by TennCare. The Office of Inspector General today announced the arrest of Willie G. McWilliams, 43, of Pulaski, after a joint investigation with the Giles County Sheriff's Department.
August 1, 2013; New York Attorney General: A.G. Schneiderman Announces Guilty Plea Of Westchester Doctor For Selling Oxycodone Prescriptions
Mount Vernon - Attorney General Eric T. Schneiderman today announced the guilty plea of Westchester anesthesiologist Dr. Arnold Roth on charges he sold prescriptions for oxycodone from his Mount Vernon home, which he also used as a medical office. Roth pleaded guilty before Dutchess County Court Judge Peter M. Forman to two felony counts, Criminal Sale of a Prescription of a Controlled Substance and Conspiracy in the Fourth Degree, for selling prescriptions for pills worth more than $480,000 on the streets
August 1, 2013; Georgia Attorney General: Georgia Recovers $540K from Settlement with Pharmaceutical Company Wyeth Over Allegations of Off-Label Marketing
Attorney General Sam Olens announced today that Georgia has joined with other states and the federal government in a $491 million dollar settlement to resolve civil and criminal allegations that Wyeth Pharmaceuticals, Inc. (Wyeth), a Delaware corporation headquartered in Collegeville, Pa., promoted the sale and use of Rapamune for uses for which it had not been approved by the Federal Drug Administration (FDA). Rapamune is a FDA approved kidney transplant drug which is prescribed to prevent the body from rejecting a donor organ that has been transplanted into the body. The total portion of the settlement amount recovered by Georgia is $540,498.11.
August 1, 2013; Arkansas Attorney General: Pulaski County Woman Arrested for Medicaid Fraud
LITTLE ROCK - Attorney General Dustin McDaniel announced today that a Little Rock health care provider has been arrested for felony Medicaid fraud following an investigation by the Attorney General's Medicaid Fraud Control Unit.
August 1, 2013; Attorney General of Georgia: Attorney General Olens Intervenes in Medicaid Fraud Lawsuit Involving Massive Kickback Scheme
Attorney General Sam Olens has intervened in a whistleblower lawsuit against Health Management Associates, Inc. (HMA, Inc.); HMA Monroe, LLC; Tenet Healthcare Corporation and its subsidiaries Atlanta Medical Center, North Fulton Hospital, Sylvan Grove Hospital and Spalding Regional Medical Center; and Clinica de la Mama (Clinica) involving a massive Medicaid fraud scheme related to illegal kickbacks.

July 2013

July 31, 2013; Maryland Attorney General: Hagerstown Man Indicted for Medicaid Fraud and Theft from Berlin Nursing and Rehabilitation Center
Baltimore, MD ( July 31, 2013) - Attorney General Douglas F. Gansler announced today that Scott Colver, 48, of Hagerstown, has been indicted by the Grand Jury for Charles County and charged with six counts of Felony Medicaid Fraud, five counts of Felony Theft, and one count of a Felony Theft Scheme.
July 30, 2013; Oklahoma Office of the Attorney General: Attorney General Pruitt Charges Lawton Counselor with Medicaid Fraud
OKLAHOMA CITY - Attorney General Scott Pruitt's Medicaid Fraud Control Unit filed charges Tuesday in Oklahoma County District Court against a self-employed Lawton counselor. Shannon Rose, 46, was charged with three counts of Medicaid fraud and one count of identity theft. According to the charges, Rose billed more than 860 fraudulent claims in excess of $78,000 to the Oklahoma Health Care Authority.
July 30, 2013; South Carolina Attorney General: S.C. Nursing Home Operator Pleads Guilty to Defrauding $1,000,000+ From State Medicaid Program
COLUMBIA, S.C.) Attorney General Alan Wilson announced Richard C. Cooke, age 53 of Lake View, S.C., pled guilty in Richland County General Sessions Court on July 17, 2013 to six (6) indictments arising from his fraudulent activity in the operation of six (6) nursing homes.
July 30, 2013; New York State Office of the Attorney General: Long Island Doctor Arrested For Selling Prescriptions For Narcotic Drugs
NEW YORK - Attorney General Eric T. Schneiderman today announced the arrest of Long Island Internist Dr. Anand Persaud, who is accused of illegally selling prescriptions for the narcotic medication oxycodone. The arrest occurred after investigators from the New York State Attorney General's Medicaid Fraud Control Unit executed a search warrant at Persaud's medical offices located at 1019 Atlantic Avenue in Baldwin and 173-25 Jamaica Avenue in Queens.
July 29, 2013; Florida Office of the Attorney General: Medicaid Fraud Control Unit and the Calhoun County Sheriff's Office Arrest Woman for Neglect of an Elderly Adult
This week, the Medicaid Fraud Control Unit and the Calhoun County Sheriff's Office arrested Shelia Angelene Mayes, a Blountstown resident, and charged her with one count of neglect of an elderly adult.
July 29, 2013; Attorney General of Georgia: Four Co-Defendants Accused of Falsely Billing Medicaid
On July 25, 2013, a Cobb County Grand Jury issued an indictment against co-defendants Garry Hankerson, Lisa Hankerson, Pierre Hixon and Londrea Buchanan on charges of violating the Georgia Racketeer Influenced and Corrupt Organizations Act (RICO) (O.C.G.A. § 16-14-4(c)), Conspiracy to Defraud the State (O.C.G.A. § 16-10-21(a)) and Medicaid Fraud (O.C.G.A. § 49-4-146.1(b)).
July 29, 2013; Attorney General of Georgia: Owner of Speech Therapy Company Charged with Stealing from Georgia Medicaid
On Thursday, July 25, 2013, a Cobb County Grand Jury indicted Timothy Robinson on four counts of Medicaid Fraud (O.C.G.A. § 49-4-146.1 (b) (1)) and four counts of Identity Fraud (O.C.G.A. § 16-9-121) for falsely billing Georgia Medicaid for services that were not provided.
July 26, 2013; Vermont Attorney General: Caregiver Charged With Medicaid Fraud And False Pretenses
Attorney General William H. Sorrell announced today that Ashley Martin, age 24, of St. Albans, Vermont, was arraigned on July 23, 2013, in Vermont Superior Court for Windsor County on nine felony counts of Medicaid Fraud and one felony count of False Pretenses. According to papers filed in court, Ms. Martin is accused of submitting claims for payments in excess of $15,000 for providing care under Vermont Medicaid's Developmental Services waiver program when she did not provide all of the claimed care.
July 26, 2013; Connecticut Division of Criminal Justice: Plainville Man Charged in Scheme to Defraud Medicaid
A Plainville man was arrested today and charged with billing the state for care he never provided to a disabled woman who allegedly concocted the overbilling scheme but then failed to deliver on his promised share of the illegal proceeds.
July 24, 2013; Attorney General of Texas: Texas Attorney General's Office Obtains $1.4 Million Settlement against Planned Parenthood Gulf Coast for Medicaid Fraud
HOUSTON - The Texas Attorney General's Office today concluded the State's Medicaid fraud investigation into Planned Parenthood Gulf Coast, Inc. Under today's agreement, Planned Parenthood Gulf Coast must pay $1.4 million for fraudulently overbilling the taxpayer-funded Medicaid program.
July 23, 2013; Kentucky Attorney General: Attorney General Announces Indictment of Mecer County Therapist in Medicaid Fraud Case
Attorney General Jack Conway today announced the indictment and arrest of a Crab Orchard, Ky. therapist following an investigation by the Attorney General's Office of Medicaid Fraud and Abuse Control. A Mercer County grand jury indicted Harold Tokle on one count of theft by unlawful taking over $10,000 and one count of intent to defraud or deceive/plan a scheme or artifice to obtain benefits from an assistance program over $10,000. Tokle surrendered at the Boyle County jail this afternoon.
July 23, 2013; Connecticut State Attorney's Office: Ninth Person Charged in Medicaid Drug Scheme
A West Hartford resident was arrested today and charged with scheming with a former doctor and others to obtain prescription drugs that were paid for by the government's Medicaid health program and then sold illegally on the streets. Lee Probulis, age 44, of Park Road in West Hartford, is the ninth person arrested as a result of an investigation conducted by the Medicaid Fraud Control Unit in the Office of the Chief State's Attorney. Two people have been convicted and more arrests are expected.
July 22, 2013; New York Attorney General: A.G. Schneiderman Announces $268k Settlement With Erie County Medical Center
BUFFALO - Attorney General Eric T. Schneiderman today announced an agreement with Erie County Medical Center (ECMC) to recover $268,493.50 in excess Medicaid payments on claims for services at its dental clinic during the period from January 1, 2006 through September 30, 2012.
July 19, 2013; Ohio Attorney General: Alpine Nursing President Sentenced to Prison in $1.9 Million Health Care Fraud Case
YOUNGSTOWN, Ohio -- Ohio Attorney General Mike DeWine today announced that the owner and president of Alpine Nursing Care, Inc. in North Randall, Ohio, will spend two years in prison after his conviction on federal health care fraud charges.
July 19, 2013; Louisiana Attorney General: Three family members arrested for Medicaid fraud
Agents with the Louisiana Attorney General's Medicaid Fraud Control Unit (MFCU) conducted an investigation into Empowering Care Services, LLC, a personal care agency located in Zachary, based on allegations the agency was billing for numerous undocumented services, as well as engaging in hiring practices that violate the state's Medicaid policy. As a result of the investigation, three personal care attendants were arrested by MFCU investigators with assistance from the East Baton Rouge Parish Sheriff's Office and booked into the East Baton Rouge Parish Prison on Wednesday.
July 18, 2013; Maryland Attorney General: AG Gansler: Baltimore Co. Caregiver Convicted and Sentenced for Abuse
Baltimore, MD - Attorney General Douglas F. Gansler announced today that Nnamdi Adiegwu, 37, of Baltimore, was convicted of Abuse of a Vulnerable Adult in the Second Degree, in the Circuit Court for Baltimore County. Judge Justin J. King sentenced the defendant to 364 days in jail, all of which was suspended. Adiegwu will be on probation for the next year and cannot be employed in any capacity with vulnerable adults.
July 18, 2013; Florida Attorney General: Attorney General Bondi's Medicaid Fraud Control Unit Arrests Three People for $27,000 of Medicaid
Fraud
Tallahassee, Fla.-Attorney General Pam Bondi's Medicaid Fraud Control Unit arrested three Central Florida residents yesterday for $27,000 worth of Medicaid fraud. An investigation conducted by the MFCU revealed that the Destiny TCM Corporation, under the ownership of Lorna Holmes and the management of Rosalyn Gentry and Deidre Padilla, billed the Medicaid program for $27,000 worth of illegitimate targeted case management services and bribed individuals in order to obtain Medicaid recipient numbers
July 18, 2013; Ohio Attorney General: Home Health Aide Sentenced to Prison for Medicaid Fraud Involving Time at Casinos, Resorts
Columbus, Ohio -- Ohio Attorney General Mike DeWine announced today that a former Cleveland-area home health aide will be going to prison for improperly billing the Ohio Department of Medicaid for more than $234,000.
July 17, 2013; South Carolina Attorney General: South Carolina Nursing Home Operator Pleads Guilty to Defrauding $1,000,000+ From State Medicaid Program
COLUMBIA, S.C.) Attorney General Alan Wilson announced Richard C. Cooke, age 53 of Lake View, S.C., pled guilty in Richland County General Sessions Court on July 17, 2013 to six (6) indictments arising from his fraudulent activity in the operation of six (6) nursing homes.
July 17, 2013; Massachusetts Attorney General: Lowell Orthodontist to Pay $800,000 Over Claims of Improperly Billing MassHealth for Dental Ex-Rays
BOSTON - A Lowell orthodontist has agreed to pay $800,000 over allegations of improperly billing the state's Medicaid program for certain dental x-rays, resulting in thousands of dollars in overpayments, Attorney General Martha Coakley announced today. Under the terms of the settlement, John Burke, D.M.D. has also agreed to permanently resign as a MassHealth provider and not treat any new patients.
July 17, 2013; Tennessee Department of Finance & Administration: Sumner Co. Man Charged With TennCare Fraud
NASHVILLE, TN - A Sumner County man is charged in Wilson County with TennCare fraud involving "doctor shopping," or using TennCare to go to multiple doctors in a short time period to obtain controlled substances. The Office of Inspector General with the assistance of the Wilson County Sheriff's Office, today announced the arrest of John P. Lamb, 42, of Gallatin.
July 16, 2013; New York Attorney General: A.G. Schneiderman Announces Sentencing Of NYC And Hudson Valley Oxycodone Kingpin
NEW YORK - Attorney General Eric T. Schneiderman today announced the sentencing of John Bland, who previously pleaded guilty to running a major oxycodone trafficking ring in New York City and Dutchess and Orange Counties. The ring used forged prescriptions to obtain and sell close to 16,000 of the highly-addictive pain pills with a street value of approximately $470,000. Bland was sentenced to five years in state prison today by Orange County Court Judge Jeffrey G. Berry.
July 16, 2013; Arkansas Attorney General: Bradley County Speech Therapist Convicted of Medicaid Fraud
LITTLE ROCK - Attorney General Dustin McDaniel announced today that a Bradley County woman has been convicted of Medicaid fraud for improperly billing the Arkansas Medicaid Program for services she did not perform.
July 15, 2013; Washington Attorney General: King County Woman Charged With Medicaid Fraud
OLYMPIA- The Attorney General's Office Medicaid Fraud Control Unit (MFCU) filed felony criminal charges against Burnice R. Thompson in Thurston County Superior Court today. Thompson was paid to care for her grandmother, a Medicaid recipient who passed away in November 2012. She is charged with one count of Theft in the First Degree and two counts of Medicaid False Statement for continuing to bill Medicaid for care hours two months after her grandmother had passed away, costing the Medicaid program $6,152.38.
July 12, 2013; New York Attorney General: A.G. Schneiderman Announces Arrest Of Brooklyn Medical Supply Company Owner And Staff In $3.2 Million Medicaid Fraud
NEW YORK - Attorney General Eric T. Schneiderman today announced the indictment of Nkem Udeh, the owner of Advance Medical Supply, Inc., her brother, Humphrey Ude, the store's manager, two of her employees, Keva Johnson and Yolane Fouche, and the Brooklyn store on top grand larceny charges for fraudulently billing Medicaid over $1.7 million dollars and HealthFirst, a health insurer for Medicaid recipients, another $1.5 million. The company and its employees billed the state Medicaid program, both directly and through managed care, on claims they dispensed nearly a million units of a highly-specialized and expensive liquid pediatric nutritional formula for kids. In fact, the company did not dispense the expensive formula. If it dispensed anything, it dispensed over-the-counter nutritional supplement formulas, such as Pediasure. The defendants face up to 25 years in prison.
July 12, 2013; New Jersey Attorney General: Owner of Cranford Home Health Aide Agency Arrested for Allegedly Billing Medicaid for Services That Were Not Provided
TRENTON - Acting Attorney General John J. Hoffman announced that the Office of the Insurance Fraud Prosecutor executed multiple search warrants today and arrested the owner/operator of a Union County home health aide agency for allegedly billing Medicaid for services that were never rendered.
July 12, 2013; Tennessee Department of Finance & Administration: Lawrence Co. Man Charged With TennCare Fraud
NASHVILLE, TN - A Lawrence County man is charged with TennCare fraud for obtaining medical treatment and using his son's TennCare benefits as payment for services for himself. The Office of Inspector General, along with the Lawrence County Sheriff's Office, today announced the arrest of 33-year old David Wayne Byrd, Sr., of Westpoint.
July 12, 2013; Tennessee Department of Finance & Administration: Davidson Co. Woman Charged With TennCare Drug Fraud
NASHVILLE, TN - Davidson County woman is charged with TennCare fraud for filling a fraudulent prescription and using TennCare healthcare insurance benefits to pay for it. The Office of Inspector General, along with the Metropolitan Nashville Police Department, today announced the arrest of Kawanna Curtis Braden, 35, of Nashville.
July 10, 2013; Tennessee Department of Finance & Administration: Tipton Co. Woman Charged With TennCare Doctor Shopping
NASHVILLE, TN - A Tipton County woman is charged in an indictment with TennCare fraud involving doctor shopping, or using TennCare to go to multiple doctors to obtain controlled substances. The Office of Inspector General, with the assistance of the Tipton County Sheriff's Office, today announced the arrest of Selena Dawn Willis, 28, of Brighton.
July 10; 2013; Washington State Office of the Attorney General: Bellevue women settle allegations of roughly $4K in Medicaid theft
OLYMPIA- The Attorney General's Office Medicaid Fraud Control Unit (MFCU) has entered into diversion agreements with two defendants in connection with falsifying timesheets as paid caregivers under the Medicaid program.
July 10, 2013; New York Attorney General: A.G. Schneiderman Announces Felony Conviction Of NYC Ambulette Company For $560k In Medicaid Fraud
Attorney General Eric T. Schneiderman today announced the conviction of Majestic Transportation, Inc., an ambulette company located in Brooklyn, for illegally subcontracting Medicaid ambulette services to a transportation company that never enrolled in the New York State Medicaid program, a practice prohibited by state law. Majestic pleaded guilty today in Kings County Supreme Court to a felony Grand Larceny charge and agreed to repay the more than$560,000 it had illegally received.
July 9, 2013; State of Alaska Department of Law: Twenty-Nine Anchorage Based Personal Care Attendants and Medicaid Recipients Charged for Medical Assistance Fraud
On July 9, 2013, the Medicaid Fraud Control Unit (MFCU) in the Alaska Department of Law announced the filing of criminal charges against 29 Anchorage based personal care attendants (PCA) and Medicaid recipients as part of an ongoing state and federal investigation into medical assistance fraud by employees of Good Faith Services, LLC (Good Faith), PCAs and Medicaid recipients receiving services from Good Faith. The following state and federal agencies collaborated on the investigation: the Anchorage Police Department; investigators with the Department of Commerce; agents with the Department of Health and Human Services, Office of Inspector General; the Social Security Administration; the Federal Bureau of Investigation; and Immigration and Customs Enforcement, Homeland Security Investigations.
July 2, 2013; Kansas Attorney General: Pretty Prairie woman sentenced on health care fraud charges
TOPEKA - A Pretty Prairie woman has been ordered to repay $50,242 and will serve one month in federal prison followed by 13 months in community confinement after being convicted of health care fraud and mail fraud, Kansas Attorney General Derek Schmidt said today.
July 1, 2013; Tennessee Department of Finance & Administration: Humphreys Co. Woman Charged 2nd Time With TennCare Fraud
NASHVILLE, TN - A Humphreys County woman is charged for the second time with fraudulently obtaining TennCare benefits by falsely claiming children in the home in order to qualify for TennCare benefits. The Office of Inspector General today announced the arrest of Lisa A. Herlein, 39, of McEwen. A Wilson County Grand Jury has charged her with TennCare fraud and theft of services over $10,000.
July 1, 2013; Tennessee Department of Finance & Administration: Arkansas Woman Charged With TennCare Fraud
NASHVILLE, TN - An Arkansas woman is charged with misrepresenting her residency - claiming to live in Tennessee - in order to obtain TennCare healthcare insurance benefits. The Office of Inspector General announced the arrest Friday of Monique A. Jones, 26, of West Memphis, Arkansas. The Shelby County Sheriff's Department assisted with this arrest.

June 2013

June 28, 2013; Tennessee Department of Finance & Administration: Shelby Co. Woman Charged With TennCare Drug Fraud
NASHVILLE, TN - A Shelby County woman is charged with TennCare fraud in nearby Haywood County for using TennCare to pay for fraudulent prescriptions. The Office of Inspector General, with assistance from Sheriff's officers in Shelby and Haywood counties, today announced the arrest of Tameka S. Harris, 22, of Memphis.
June 28, 2013; Massachusetts Attorney General: Fall River Woman Indicted for Stealing More Than $230,000 From MassHealth in Multi-Year Scheme
FALL RIVER - A Fall River woman has been indicted for a multi-year scheme that defrauded more than $233,000 from the state's Medicaid program by falsely billing for her brother's personal care attendant (PCA) services, Attorney General Martha Coakley announced today. The woman's nephew was also indicted in connection with the preparation of false Massachusetts tax returns as part of the alleged fraud.
June 27, 2013; Florida Attorney General: Attorney General Bondi's Office Arrests Lake County Resident for More Than $300,000 in Medicaid Fraud
TALLAHASSEE, Fla. -Attorney General Pam Bondi's Medicaid Fraud Control Unit today arrested a Lake County resident, Randall Ritch, for allegedly committing more than $300,000 in Medicai fraud. Ritch, owner of Lake County Preferred OBGYN, allegedly billed the Florida Medicaid program for services that were never rendered and used the Medicaid provider number of a physician no longer in his employment. According to the investigation, Ritch submitted more than 2,500 fraudulent claims to the Medicaid program.
June 27, 2013; Tennessee Department of Finance & Administration: Wilson Co. Woman Charged With TennCare Drug Fraud
NASHVILLE, TN - - A Wilson County woman is charged with TennCare fraud for selling prescription drugs paid for by TennCare. The Office of Inspector General today announced the arrest of Mary Daniell Gibson, 24, of Lebanon, after a joint investigation with the Lebanon Police Department.
June 26, 2013; Louisiana Attorney General: Columbia woman arrested for cheating Medicaid program
A Columbia woman has been arrested and charged with Medicaid fraud and filing or maintaining false public records, announced the Louisiana Attorney General's Criminal Division.
June 25, 2013; Kansas Attorney General: Labette County woman ordered to repay $3,500 for Medicaid fraud
Parsons - A Labette County woman was ordered yesterday to repay $3,500 to the Kansas Medicaid program after pleading guilty to Medicaid fraud, Kansas Attorney General Derek Schmidt said.
June 24, 2013; Tennessee Department of Finance & Administration: Dickson Co. Man Charged With TennCare Drug Fraud
NASHVILLE, TN - A Dickson County man is charged with TennCare fraud for selling prescription drugs that were paid for with TennCare healthcare insurance benefits. The Office of Inspector General today announced the arrest of Michael J. Dotson, 40, of Dickson, after a joint investigation with the Dickson Police Department.
June 20, 2013; Florida Attorney General: Illegal Assisted Living Facilities Closed Due To Reports Of Neglect
Marion County, FL - The Marion County Sheriff's Office, in conjunction with the Medicaid Fraud Unit of the Attorney General's Office, Agency for Healthcare Administration and the Florida Department of Children and Family Services, has arrested Mary Alexander and Tara Collins-Johnson for illegally operating assisted living facilities without a license and neglect of an elderly/disabled person.
June 20, 2013; Connecticut State Attorney Office: Marriage And Family Counselor Charged With Medicaid Fraud
A licensed Marriage and Family Counselor was arrested today for allegedly submitting dozens of false claims for payment to the state's Medicaid program. Medicaid is a federal system of health insurance for those requiring financial assistance that is subsidized by federal and state funds. Catherine A. Reardon, age 49, of Crescent Street, Groton, is accused of defrauding Medicaid of more than $3,500 by submitting 72 claims for counseling services that were not provided to seven current or former clients.
June 20, 2013; Tennessee Department of Finance & Administration: Crockett Co. Woman Charged With TennCare "Doctor Shopping"
NASHVILLE, TN - A Crockett County woman is charged in a Gibson County indictment with TennCare fraud involving "doctor shopping," or using TennCare to go to multiple doctors in a short period of time to obtain controlled substances. The Office of Inspector General, with the assistance of the Gibson County Sheriff's Office, today announced the arrest of Robin S. Brumett, 48, of Alamo.
June 20, 2013; Tennessee Department of Finance & Administration: Sumner Co. Woman Charged 2nd Time With TennCare "Doctor Shopping"
NASHVILLE, TN - A Sumner County woman is charged for a second time with "doctor shopping," or using TennCare to go to multiple doctors in a short period of time to obtain controlled substances. The Office of Inspector General, with the assistance of the Williamson County Sheriff's Office, today announced the arrest of 32-year old Katherine L. Fry, of Whitehouse.
June 19, 2013; New York Attorney General: NYC Pharmacy And Clinic-Based Criminal Enterprise Charged With $16 Million Theft And Fraud Perpetrated On Medicaid
NEW YORK -- Attorney General Eric T. Schneiderman today announced the indictment of six individuals and three corporations in a $16 million, multi-year scheme to steal from Medicaid. The scam targeted vulnerable HIV patients, mainly in the Bronx, putting their lives in jeopardy by paying them not to fill their HIV prescriptions and then billing Medicaid for those unfilled prescriptions. The indictment, unsealed in Bronx Supreme Court today, alleges top charges of Enterprise Corruption and Grand Larceny in the First Degree against all of the defendants, including ring leader Mujahid a/k/a "Peter" Pervez, who illegally operated as many as 11 pharmacies in New York City and on Long Island, and by Richard Cedeno, the top prescribing physician assistant in New York State for highly addictive Class II narcotic drugs. Pervez, Cedeno and their co-conspirators, including two supervising pharmacists, face up to 25 years behind bars.
June 19, 2013; Tennessee Department of Finance & Administration: Sumner County Woman Charged With TennCare Fraud
NASHVILLE, TN - A Sumner County woman is charged with TennCare fraud and theft of services after receiving TennCare benefits she was not eligible for. The arrest brings the total number of people arrested for TennCare fraud to 1,924 since the Office of Inspector General (OIG) began investigating and pursuing this criminal activity.
June 19, 2013; Tennessee Department of Finance & Administration: Cheatham Co. Woman Charged With TennCare Fraud In Cheatham And Wilson Counties
NASHVILLE, TN - A Cheatham County woman is charged with TennCare fraud in two separate incidents where she's accused of falsely claiming a dependent in order to qualify for TennCare benefits. The Office of Inspector General (OIG) today announced the arrest of Brittney Diane Hooberry, 25, of Ashland City. She is charged in indictments from Cheatham and Wilson Counties with TennCare fraud and theft of services.
June 18 2013; Mississippi Attorney General: Greenville Resident Facing Seven Counts of Medicaid Fraud
Jackson, MS - A Greenville resident has been indicted and arrested on charges of Medicaid Fraud, announced Attorney General Jim Hood today. Marguerite Wilson, 31, of Greenville turned herself in to the Washington County Sheriff's Office June 11 following indictment by a Washington County grand jury on seven counts of Medicaid Fraud.
June 17, 2013; Kentucky Attorney General: Attorney General Conway Announces Indictments in Medicaid Fraud Case
Kentucky Attorney General Jack Conway today announced the indictments of William Qualls and Linda Smith for allegedly defrauding the Kentucky Medicaid Program. Qualls and Smith, who worked as caregivers for a disabled Medicaid recipient, are each charged with Devising or Engaging in a Scheme to Defraud the Kentucky Medicaid Program and Theft by Unlawful Taking Over $500 but under $10,000.
June 17, 2013; Tennessee Department of Finance & Administration: Former Kentucky Couple Charged With Fraud In Obtaining TennCare Benefits
NASHVILLE, TN - A former Kentucky couple is charged with misrepresenting their residency in order to obtain TennCare healthcare insurance and food stamp benefits. The Office of Inspector General today announced the arrest of James N. Houchin, 45, and his wife Ruby A. Houchin, 42, of Bethpage.
June 17, 2013; Tennessee Department of Finance & Administration: Sumner Co. Woman Charged With TennCare "Doctor Shopping"
NASHVILLE, TN - A Sumner County woman is charged in an indictment for TennCare fraud involving "doctor shopping," or using TennCare to go to multiple doctors to obtain prescriptions for a controlled substance. The Office of Inspector General with the assistance of the Sumner County Sheriff's Office, today announced the arrest Katherine L. Fry, 32, of Whitehouse.
June 14, 2013; Arkansas Attorney General: St,. Francis County Woman Arrested on Medicaid Fraud Charge
LITTLE ROCK -- Attorney General Dustin McDaniel announced today that a St. Francis County woman has been arrested for felony Medicaid fraud following an investigation by the Attorney General's Medicaid Fraud Control Unit.
June 13, 2013; Virginia Attorney General: Provider Of Home Health Care Services Sentenced For Medicaid Fraud
Norfolk, Va. - Angie L. Gilchrist, 58, of Suffolk, Va., was sentenced today to 33 months in prison, followed by a three year term of supervised release, for defrauding the Virginia Medicaid Program, a health care program for indigent persons that is jointly funded by the federal government and the State of Virginia. She was also ordered to make restitution to the Virginia Medicaid Program in the amount of $294,713.00.
June 13, 2013; Washington Attorney General: Spokane area woman charged with $30K in Medicaid fraud
OLYMPIA- The Attorney General's Office Medicaid Fraud Control Unit (MFCU) has charged an Otis Orchards woman with one count of 1st degree theft and two counts of making a false statement to obtain a Medicaid payment.
June 13, 2013; Connecticut State Attorney's Office: Eighth Person Charged in Illegal Drug Scheme
A former New Britain resident was arrested today and charged with scheming with a former doctor to obtain prescription drugs that were paid for by a government health program and then sold illegally on the streets.
June 12, 2013; New York Attorney General: A.G. Schneiderman Recovers $2.5 Million In Nursing Home Medicaid Kickback Scheme
NEW YORK - Attorney General Eric T. Schneiderman today announced a settlement with the estate of a late Bronx nursing home owner who was previously indicted on charges of paying thousands of dollars in kickbacks to a hospital social worker to steer patients to Kingsbridge Heights Rehabilitation and Care Center, Inc. The agreement with the estate of Helen Sieger returns more than $2.5 million to the New York State Medicaid program.
June 12, 2013; New York Attorney General: A.G. Schneiderman Announces Guilty Plea By Oxycodone Kingpin
NEW YORK - Attorney General Eric T. Schneiderman today announced that John Bland pleaded guilty to charges that he directed a major oxycodone trafficking ring that used forged prescriptions at pharmacies throughout New York City and Orange County to obtain and sell the highly addictive painkillers.
June 10, 2013; Tennessee Department of Finance & Administration: Warren Co. Woman Charged With TennCare Drug Fraud
NASHVILLE, TN - A Warren County woman is charged with TennCare fraud for apparently selling prescription drugs paid for by TennCare. The Office of Inspector General today announced the arrest of Deborah Ann Evans, 45, of Manchester, after a joint investigation with the Warren County Sheriff's Office. She is charged with TennCare fraud and two counts of delivery of Schedule III controlled substance.
June 10, 2013; Tennessee Department of Finance & Administration: Rutherford County Woman Charged With TennCare Drug Fraud
NASHVILLE, TN - A Rutherford County woman is charged with TennCare fraud in connection with fraudulent prescriptions for drugs. The Office of Inspector General, with the assistance of the Rutherford County Sheriff's Office, today announced the arrest of Kaylee R. Burgess, 28, of Murfreesboro. She is charged with six counts of TennCare fraud.
June 10, 2013; Tennessee Department of Finance & Administration: Wilson County Woman Charged With TennCare Drug Fraud
NASHVILLE, TN - A Wilson County woman is charged with TennCare fraud in nearby Rutherford County, where she's accused of selling prescription drugs which were paid for by TennCare. The Office of Inspector General today announced the arrest of Jennifer J. Creque, 33, of Lebanon, after a joint investigation with the Smyrna Police Department Narcotics Division.
June 10, 2013; Tennessee Department of Finance & Administration: Warren County Man Charged With TennCare "Doctor Shopping"
NASHVILLE, TN - A Warren County man is charged in a Putnam County indictment with TennCare fraud involving "doctor shopping," or using TennCare to go to different doctors in a short period of time in order to obtain a controlled substance. The Office of Inspector General, with the assistance of the Warren and Putnam County Sheriff's Offices, today announced the arrest of Charles A. Driver, 36, of McMinnville. He is charged with fraudulently using TennCare to obtain prescriptions for the painkiller Hydrocodone by "doctor shopping."
June 10, 2013; Tennessee Department of Finance & Administration: Davidson County Woman Charged With TennCare Fraud
NASHVILLE, TN - A Davidson County woman is charged with TennCare fraud in nearby Wilson County. Authorities say Toni R. Petty, 42, of Hermitage, claimed to have a child in her home for the purpose of making herself eligible for TennCare benefits. The Office of Inspector General today announced the Petty's arrest, with assistance from the Wilson County Sheriff's Office. She is charged with two counts of TennCare fraud and one count of theft of services.
June 10, 2013; Nevada Attorney General: Attorney General Masto Announces Sentencing of Las Vegas Personal Care Assistant
Las Vegas, NV - Nevada Attorney General Catherine Cortez Masto announced that Ernesto Guerra-Perez, 45, of Las Vegas, was sentenced today in a Medicaid fraud case involving failure to maintain adequate records to support Medicaid claims.
June 8, 2013; New York Attorney General: A.G. Schneiderman Announces Arrest Of Nursing Home Director For Endangering Resident With Dementia
QUEENS - Attorney General Eric T. Schneiderman announced today that the former Director of Nursing Services for a Queens nursing home was arrested for falsifying facility records to cover-up that a 74 year old resident, Alan Frazer, who suffers from dementia, was missing from the facility.
June 7, 2013; Louisiana Attorney General: AG's Medicaid Fraud Control Unit Arrests Two Caregivers
Two personal care attendants have been charged with Medicaid fraud for filing false claims, announced Louisiana Attorney General Buddy Caldwell.
June 7, 2013; Louisiana Attorney General: Columbia woman charged with Medicaid fraud
A Columbia woman has been booked with Medicaid fraud for filing false claims, announced Louisiana Attorney General Buddy Caldwell. Erlene Linder, 58, of 402 White Perch Road, surrendered to Medicaid Fraud Control Unit investigators today for arrest and was charged with one count of Medicaid fraud and one count of filing false public records.
June 4, 2013; Louisiana Attorney General: Former DHH Employee Arrested for Defrauding the State's Medicaid Program of More Than $1 Million
A former accountant for the Louisiana Department of Health and Hospitals (DHH) was arrested today and charged with defrauding the state out of more than $1 million, announced Attorney General Buddy Caldwell.
June 4, 2013; Connecticut Attorney General: Attorney General Reaches $9.9 Million Settlement With Key Defendants in Medicaid Billing Lawsuit
Attorney General George Jepsen today announced a $9.9 million settlement with Gary Anusavice of North Kingstown, R.I., and six of his management and consulting companies, settling the state's civil fraud claims stemming from an alleged illegal Medicaid billing scheme.
June 3, 2013; Tennessee Department of Finance & Administration: Hamblen County Woman Charged With TennCare Drug Fraud
NASHVILLE, TN - A Hamblen County woman is charged with TennCare fraud for using the program to pay for a fraudulent prescription. The Office of Inspector General, with the assistance of the Morristown Police Department, today announced the arrest of Jacqueline N. McCravey, 26, of Morristown. McCravey is charged with TennCare fraud in an indictment that says she took a forged prescription for the painkiller Lortab to a Hamblen County pharmacy.
June 3, 2013; Tennessee Department of Finance & Administration: Bradley County Woman Charged With TennCare Fraud
NASHVILLE, TN - A Bradley County woman is charged with TennCare fraud. The Office of Inspector General today announced the arrest of Mary Hembree, 47, of Cleveland, after a joint investigation with the Bradley County Sheriff's Office. Hembree is charged with TennCare fraud in an indictment accusing her of knowingly obtaining TennCare healthcare insurance benefits through a false statement, representation, or impersonation or by concealment of a material fact or other fraudulent means.
June 3, 2013; Tennessee Department of Finance & Administration: Cannon County Woman Charged With TennCare Fraud
NASHVILLE, TN - A Cannon County woman is charged with TennCare fraud after receiving healthcare insurance benefits she wasn't entitled to receive. The Office of Inspector General today announced the arrest of Pamela Climer-LaFever, 43, of Woodbury.
June 3, 2013; Tennessee Department of Finance & Administration: Shelby County Man Charged With TennCare Fraud
NASHVILLE, TN - A Shelby County man is charged with TennCare fraud. The Office of Inspector General, with the assistance of the Shelby County Sheriff's Office, today announced the arrest of Carlton King, 47, of Memphis. King was indicted by a Shelby County Grand Jury and charged with TennCare fraud for fraudulently obtaining TennCare healthcare insurance benefits he was not entitled to receive.

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