Attorney General Loretta E. Lynch and Department of Health and Human Services (HHS) Secretary Sylvia Mathews Burwell announced last June a nationwide sweep led by the Medicare Fraud Strike Force in 17 districts, resulting in charges against 243 individuals, including 46 doctors, nurses and other licensed medical professionals, for their alleged participation in Medicare fraud schemes involving approximately $712 million in false billings.
Editor's Note: We reported to Medicare double billings we had received for a service at a medical facility a couple of years ago. Medicare told us that they were going to report our experience as fraud. We felt that we should show you examples of State Enforcement Actions that take place continuously. In order to cut down on fraud cited by some members Congress as a reason to change, reduce or privatize the system, we have to carefully review what Medicare has paid and make sure there are no irregularities in payments to providers. Read carefully your Explanations of Benefits to find this kind of fraud and reduce costs.
Office of Inspector General U.S. Department of Health and Human Services
State Enforcement Actions
State Enforcement ArchiveSeptember 2015
- September 28, 2015; New York Attorney General
- A.G. Schneiderman Announces Guilty Plea Of Rochester Nurse For Defrauding Medicaid Of Over One Thousands Dollars In One Month
ROCHESTER-Attorney General Eric T. Schneiderman announced the guilty plea of Licensed Practical Nurse (L.P.N.) Tera Poles, 33 of Rochester, for allegedly stealing $1,355.07 from the Medicaid program by billing for numerous hours that she did not work. Poles was employed at a private facility to provide nursing services for a special needs child. - September 26, 2015; Georgia Department of Law
- Two Plead Guilty To Medicaid Fraud
Steven Platt, a North Carolina resident, entered a plea of guilty to two counts of Medicaid Fraud today in Dekalb County Superior Court. The Court sentenced Mr. Platt to serve 2 years in prison, followed by 12 years of probation, and restitution in the amount of $400,000.00. - September 25, 2015; New York Attorney General
- A.G. Schneiderman Announces Arrest, Arraignment And Guilty Plea Of Chili Nurse For Allegedly Defrauding Medicaid Of Nearly $4k
CHILI - Attorney General Eric T. Schneiderman today announced the arrest, arraignment and guilty plea of Tara Chimino, a licensed practical nurse who was employed to provide private nursing services to a special needs young adult. Chimino was charged with stealing $3,841.40 from the Medicaid program by billing for numerous hours that she did not work. - September 24, 2015; Florida Attorney General
- Orange County Dentist Arrested for Defrauding Medicaid Out of More Than $5,500
TALLAHASSEE, Fla.-Attorney General Pam Bondi's Medicaid Fraud Control Unit and the Altamonte Springs Police Department today arrested an Orange County dentist for allegedly defrauding the Florida Medicaid program. According to the investigation, Dr. Merys Downer-Garnette billed for services that were never rendered, not rendered as billed or double-billed, causing more than $5,500 in fraudulent claims to the state's Medicaid program. - September 24, 2015; Tennessee Department of Finance and Administration
- Knox Co. Woman Sentenced To 15 Years for TennCare Fraud
NASHVILLE, Tenn. - A Knox County woman arrested four times for TennCare fraud involving prescription drugs must now serve 15 years in state custody. - September 24, 2015; Mississippi Attorney General
- Clarksdale Caregiver Charged with Assaulting and Threatening Elderly Woman
Caralee Ann Unruh, 51, of Clarksdale, has been arrested and charged with one felony count of simple assault of a person over the age of 65, announced Attorney General Jim Hood. - September 23, 2015; Tennessee Department of Finance and Administration
- Wilson Co. Man Charged with TennCare Fraud
NASHVILLE, Tenn. - A Wilson County man is charged with TennCare fraud for selling prescription drugs that were purchased using TennCare benefits. - September 23, 2015; Tennessee Department of Finance and Administration
- Cannon Co. Woman Charged 3rd Time with TennCare Fraud
NASHVILLE, Tenn. - A Cannon County woman is charged for the third time with doctor shopping for prescription drugs, using TennCare benefits as payment. - September 18, 2015; Arkansas Attorney General
- Rutledge Announces Medicaid Fraud Arrest of Pulaski County Woman
LITTLE ROCK - Arkansas Attorney General Leslie Rutledge announced the arrest of a Pulaski County woman by the Attorney General's Medicaid Fraud Control Unit. - September 18, 2015; Tennessee Department of Finance and Administration
- Mississippi Woman Charged With TennCare Fraud
NASHVILLE, Tenn. - A Mississippi woman is charged with TennCare fraud and theft of property after she received healthcare insurance benefits through the state's healthcare insurance program, even though she was not eligible. - September 15, 2015; Tennessee Department of Finance and Administration
- Stewart Co. Woman Charged With TennCare Fraud
NASHVILLE, Tenn. - A Stewart County woman is charged with TennCare fraud involving illegally selling prescription drugs that were paid for with TennCare benefits. - September 11, 2015; Georgia Attorney General
- Two Plead Guilty to Medicaid Fraud
On September 10th, 2015, Derrell Jackson and Shayla Darrington Jackson pled guilty to one count of Medicaid Fraud each. Gwinnett County Superior Court sentenced Derrell Jackson to ten years in jail which he is to serve three and the balance on probation. Shayla Jackson was sentenced to ten years but to serve two under a work release program. The court also ordered $605,000.00 in restitution. - September 10, 2015; Washington Attorney General
- AG alleges Clark County dentists collected $1 million in fraudulent Medicaid payments
VANCOUVER - Attorney General Bob Ferguson today announced a civil lawsuit against CareOne Dental Corporation, its owner, Dr. Liem Do, and his wife, Dr. Phuong-Oanh Tran, for alleged Medicaid fraud. CareOne is a dental services provider with four offices in Washington, including two located in Vancouver. - September 10, 2015; Arkansas Attorney General
- Attorney General's Medicaid Fraud Control Unit Arrests Pulaski County Woman
LITTLE ROCK - Arkansas Attorney General Leslie Rutledge announced the arrest of a Pulaski County woman by the Attorney General's Medicaid Fraud Control Unit. - September 10, 2015; New York Attorney General
- A.G. Schneiderman Announces Guilty Plea Of Capital Region Nurse For Illegally Obtaining More Than 2,000 Narcotics Using Forged Prescriptions
SCHENECTADY - Attorney General Eric T. Schneiderman today announced the guilty plea of Linda Masse, a Licensed Practical Nurse, to a felony, for illegally obtaining narcotics by presenting prescriptions to pharmacies with the forged signature of her employer, a Medicaid provider. Masse admitted to being in possession of forged prescriptions which she used to get Hydrocodone and Oxycodone that were paid for by Medicaid. - September 10, 2015; New York Attorney General
- A.G. Schneiderman Announces Arrest Of Former Nursing Home Employee Charged With Stealing From Nursing Home Residents
HUDSON--Attorney General Eric Schneiderman today announced the arrest and arraignment of Claire Wieland, 28 of White Plains for allegedly stealing more than $6,000 from a resident trust account at the Livingston Hills Nursing and Rehabilitation Center in Columbia County. - September 9, 2015; Pennsylvania Attorney General
- Additional Golden Living nursing homes added to legal action
HARRISBURG - Attorney General Kathleen G. Kane today announced her office has filed an amended legal action against a chain of nursing home companies accused of misleading consumers by failing to provide basic services to elderly and vulnerable residents. - September 9, 2015; New York Attorney General
- Westchester Transportation Company Owner Sentenced To Jail For Stealing Over $200k From Medicaid
PEARL RIVER - Kurien Palliankal, 48, of Yonkers, owner of Carewell Ambulette, Inc., was sentenced in Westchester County Court today to six months in jail for stealing from Medicaid, Attorney General Eric T. Schneiderman announced. He also was sentenced to five years probation after he serves his jail sentence. The corporation, formerly based in New Rochelle, was also sentenced to pay a fine of $10,000. - September 4, 2015; Louisiana Attorney General
- Three Arrested for Defrauding Louisiana Medicaid
Attorney General James D. "Buddy" Caldwell announced today that three individuals have been arrested this week and charged with defrauding the state's Medicaid program. - September 3, 2015; Tennessee Department of Finance and Administration
- Knox Co. Woman Charged With TennCare Fraud
NASHVILLE, Tenn. - A Knox County woman is charged with TennCare fraud in nearby Anderson County in a case involving prescription drugs.
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