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State Enforcement Actions

State Enforcement Archive

April 2014

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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