Latest news with #MedicaidFraudControlUnit
Yahoo
01-07-2025
- Yahoo
Local health care workers charged with Medicaid fraud
[Watch in the player above: What's the difference between Medicare and Medicaid?] COLUMBUS, Ohio (WJW) — Thirteen Ohio health care providers are now charged with felonies for allegedly defrauding Medicaid, billing the federal government a combined more than $180,000 for services they did not provide, according to authorities. The alleged fraud was investigated by the Medicaid Fraud Control Unit in Attorney General Dave Yost's office, according to a Monday news release. 'Billing for made-up services checks every box for fraud, waste and abuse,' Yost is quoted in the release. 'Medicaid fraud steals from the vulnerable and from the taxpayers who fund the program — and we don't tolerate that in Ohio.' Accused serial shoplifter arrested in local Kohl's parking lot; linked to $51K in stolen merchandise Among those indicted are 12 home health aides and one behavioral health specialist, according to the release. Ten of the providers are in Northeast Ohio: Donna Deaver, 63, of Cleveland, is accused of billing for services performed while the recipient was in Jamaica on a six-month vacation, according to the release. She allegedly used the names of two family members, who were also Medicaid providers, 'telling them the extra income came from a pandemic incentive program,' reads the release. It was a $64,316 loss for Medicaid. Natosha Hall, 32, of Cleveland, is accused of seeking reimbursement for services she allegedly performed while on a trip to Barbados. The loss totaled $1,037. Rachelle Monday, 29, of Cleveland, is accused of falsifying time sheets while working at Warm Living Health Care in Parma. At the time she claimed to be working, she was actually working another job as a parking lot attendant, according to Yost's office. The loss totaled $16,041. Gerald Patterson, 57, of Akron, is accused of falsifying time sheets while working at Enterprise Health Services in Akron, billing for services performed while he was working a second job and traveling out of state, according to Yost's office. The loss totaled $6,184. Tara Patterson, 46, of Akron, admitted to billing multiple times for services she did not provide while out of state, as part of a kickback scheme with the recipient of the services, according to Yost's office. The loss totaled $15,210. Thong Phaphouvaninh, 64, of Orrville, and Bounmy Thammavongsa, 60, of Perrysburg, reportedly confessed to billing for services they claimed to have provided while working for Pinnacle Home Health of Tallmadge, despite being hours away from the recipients at the time. The loss totaled $33,416. Patric Snowden, 49, of Maple Heights, reportedly confessed to billing for services she allegedly provided while she was actually on trips to warm travel destinations in the U.S., as well as the Dominican Republic, France and Jamaica. The loss totaled $2,318. Janay Veal, 37, of Youngstown, is accused of continuing to bill Medicaid for services provided to a recipient even after being removed from the patient's care plan, and on days when the recipient's family member had provided the care. The loss totaled $4,923. Miranda Williams, 30, of Mentor, worked with students as a behavioral health specialist for GuidingPoint of Cleveland, according to the release. She allegedly billed for numerous services though she wasn't actually at her assigned school. Some of her claims also 'overlapped with other claims she submitted at a separate counseling job,' reads the release. The loss totaled $26,915. 6 killed in Howland plane crash identified Erica Gore, 35, of Columbus, allegedly billed for services that had been canceled at the last minute. The recipient's family members showed text messages confirming that Gore had canceled services on 37 days for which she had claimed reimbursement, according to the release. The loss totaled $2,033. Donna Wells, 35, of Cincinnati, allegedly billed for services for recipients who were hospitalized, while Wells was traveling in Georgia and Nevada, according to the release. The loss totaled $3,183. The takedown was part of a nationwide federal crackdown on health care fraud and illegal drug diversion schemes that revealed $14.6 billion in false billings and 15.6 million pills of controlled substances that had been illegally diverted. Authorities seized $245 million in cash, luxury cars and more, according to the release. Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
Yahoo
05-06-2025
- Health
- Yahoo
Owner of CT counseling practice sentenced to conditional discharge for defrauding Medicaid of $27K
An Avon woman has been sentenced to conditional discharge for defrauding the Medicaid program out of more than $25,000. Soraya Sawicki, 64, was sentenced on Tuesday in Hartford Superior Court to 18 months in prison, suspended, and five years of conditional discharge, according to the Connecticut Division of Criminal Justice. One of her conditions stipulates that she cannot serve as a provider in the Medicaid program. DCJ officials said Sawicki paid full restitution as part of the plea deal she accepted. The deal required her to plead guilty to one felony count of health insurance fraud, officials said. According to officials, Sawicki was a licensed clinical social worker and the owner of Infinity Integrated Counseling and Spa Services, LLC, in Avon. An investigation by the inspectors of the Medicaid Fraud Control Unit in the Office of the Chief State's Attorney found that she billed for services that were never provided, defrauding the program out of $27,068 between September of 2019 and June of 2021. The fraud unit was assisted in the investigation by the State of Connecticut Department of Social Services Office of Quality Assurance and the Avon Police Department. Because she was convicted of a program-related felony, Sawicki is subject to a 'mandatory exclusion as a health care provider to certain federally funded health programs pursuant to federal and state laws and regulators,' DCJ officials said. Anyone with knowledge of suspected fraud or abuse in the public healthcare system is asked to contact the Medicaid Fraud Control Unit at the Office of the Chief State's Attorney at 860-258-5986.
Yahoo
03-06-2025
- Business
- Yahoo
Owners of Las Vegas health company ordered to pay $1M for Medicaid fraud
LAS VEGAS (KLAS) — Camille Funches, Rodshiekka Chester and their company, Building Resilience, were found guilty of fraudulently billing Medicaid for services that were not performed. The investigation of the company began after the Medicaid Fraud Control Unit received a referral for services not being provided by Building Resilience. According to the Nevada Attorney General's office, the investigation showed that Funches and Chester oversaw the billing services and knew the services weren't provided to Medicaid recipients, yet billed for them. Interviews with Medicaid recipients also confirmed that they either didn't receive the service, or the number of services that were billed was incorrect. Funches and Chester were placed on probation for two years and have a suspended sentence of 19 to 48 months. They were also ordered to pay restitution of $1 million to Medicaid. Suspected Medicaid fraud can be reported to the MFUC at (702) 486-3420 or (775) 684-1100. A complaint can also be submitted to the Nevada Attorney General's office at this link. Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
Yahoo
08-05-2025
- Health
- Yahoo
Georgia woman charged with Medicaid fraud in Connecticut
WATERBURY, Conn. (WTNH) — A Georgia woman was arrested by the Coweta (Ga.) County's Sheriff's Office on a Connecticut warrant, and extradited to Connecticut for allegedly defrauding Medicaid by billing for services she did not provide. Brittany Gresham, age 36, of Senoia, Ga., was extradited by the Medicaid Fraud Control Unit in the Office of the Chief State's Attorney and charged with one count of first-degree larceny by defrauding a public community, one count of health insurance fraud, one count of conspiracy to commit first-degree larceny by defrauding a public community, and one count of conspiracy to commit health insurance fraud. Gresham allegedly enrolled as a Personal Care Assistant (PCA) in the Connecticut Medical Assistants Program (CMAP). The PCA program, providing an alternative to entering an assisted living facility, is a Medicaid-funded program which provides recipients who have permanent, severe, and/or chronic disabilities, funds to hire PCAs to physically assist them with daily self-care. According to the investigation by the Medicaid Fraud Control Unit, that between March 2021-July 2023, Gresham while living in Georgia, and the co-defendant, Tywan Marion, with Gresham's knowledge, allegedly completed a job application for Gresham and submitted time sheets on her behalf for PCA services she did not provide to a Connecticut recipient. Gresham allegedly received payment from Medicaid for the unrendered services and transfer some of the money to Marion. Gresham allegedly received a total of $44,476.57 from the scheme. Gresham was arraigned in Waterbury Superior Court on Wednesday and is being held on a $100,000 surety bond. Marion, who was previously arrested, is being held on a $200,000 surety bond. All charges are each classified as B felonies and punishable by up to 20 years in prison. Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed. For the latest news, weather, sports, and streaming video, head to
Yahoo
29-04-2025
- Yahoo
Arkansas Attorney General Tim Griffin announces arrest of father-son pair for Medicaid fraud
LITTLE ROCK, Ark. – Arkansas Attorney General Tim Griffin announced the arrest of a father and son for Medicaid fraud on Monday. The announcement from Griffin's office stated that 52-year-old Ronald Alfred Vail and 27-year-old Garrett Bradley Vail, both of Van Buren, each pleaded guilty to a single count of felony Medicaid fraud. Each man received a term of three years' probation, a $1,500 fine and was ordered to pay court costs and $3,444.25 in restitution. Arkansas Attorney General Tim Griffin announces financial fraud task force Officials said Ronald helped Garrett bill for Medicaid services for Garrett's sibling, but the services were never provided and the two shared the proceeds from the billings. Griffin complimented his office's Medicaid Fraud Control Unit for its commitment. He also thanked Special Agent Matthew Edwards, Assistant Attorney General David Jones, and Will Jones, prosecuting attorney for the 6th Judicial District. Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
