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State Enforcement Actions

State Enforcement Archive

October 2020

October 15, 2020; Massachusetts Attorney General
AG Healey Indicts Seven Individuals in Connection With Personal Care Attendant Fraud
BOSTON - Attorney General Maura Healey announced today that her office secured indictments against seven individuals in connection with a coordinated criminal sweep of fraud and abuse in the state's Personal Care Attendant (PCA) program offered by MassHealth.
October 14, 2020; Indiana Attorney General
AG Hill: Medicaid fraud investigation leads to sentence that includes $646,000 restitution payment
Attorney General Curtis Hill said today that the sentencing of a Fort Wayne woman demonstrates the seriousness with which authorities view the crime of health care fraud in connection with the Medicaid program.
October, 13, 2020; Tennessee Bureau of Investigation
Joint Investigation Results in Indictment of Sevierville Doctor and Two Patients
SEVIER COUNTY - A joint investigation by Special Agents with the Tennessee Bureau of Investigation Medicaid Fraud Control Division, the Tennessee Office of Inspector General, the Tennessee Department of Health Division of Health Related Boards, United States Department of Health and Human Services, and the Federal Bureau of Investigation has resulted in the indictment and arrest of a Sevierville doctor and two of his patients.
Oct 12, 2020; Missouri Attorney General
Attorney General Schmitt Announces Updated Settlement with Opioid Manufacturer Mallinckrodt
Attorney General Schmitt today announced an update to a global settlement framework agreement between state attorneys general, local subdivisions, and the opioid manufacturer Mallinckrodt (MNK), its subsidiaries, and certain other affiliates. Under the new settlement, MNK will pay $1.6 billion into a trust as described below. MNK is currently the largest generic opioid manufacturer in the United States.
October 9, 2020; New York Attorney General
Attorney General James Charges Bronx Clinic Owner With Stealing More Than $4 Million From New York Taxpayers: Leslie Montgomery Allegedly Offered Fraudulent Affordable Housing to Scam Low-Income New Yorkers Into Revealing Their Personal Identifying Information
NEW YORK - Attorney General Letitia James today announced charges against Leslie Montgomery, 49, of the Bronx and her healthcare clinic, Healthy Living Community Center (Healthy Living), for defrauding the New York State Medicaid program by submitting false claims to Medicaid and to MetroPlus, a Medicaid-funded managed care organization (MCO), for customized back braces.
October 8, 2020; Massachusetts Attorney General
Lawrence Physician to Pay $515,000 over Allegations of False Billing and Charging Cash for Suboxone: Settlement Also Resolves Allegations of Billing for Physician Office Visits Performed by Unlicensed Medical Assistants
Boston - A Lawrence physician and members of his practice will pay $515,000 to resolve allegations that they charged patients cash for a substance use disorder treatment already covered by the state's Medicaid program (MassHealth), and billed for office visits that should have been performed by a physician but were instead performed by unlicensed medical assistants, Attorney General Maura Healey announced today.
Oct 6, 2020; Missouri Attorney General
Pettis County Man Pleads Guilty to Medicaid Fraud, Must Pay $6,000 in Restitution
Missouri Attorney General Eric Schmitt announced today that on September 8, 2020, Sherwin D. Marshall pled guilty to the class D felony of Violations Involving Health Care Payments in the Circuit Court of Pettis County.
October 2, 2020; Pennsylvania Attorney General
AG Shapiro, Bucks County DA Weintraub Charge Quakertown Doctor with Insurance Fraud, Forging Prescriptions
HARRISBURG - Attorney General Josh Shapiro and Bucks County District Attorney Matthew Weintraub today announced the arrest of a Quakertown doctor following two separate investigations into forged prescriptions and a faked disability claim.
October 2, 2020; New York Attorney General
Attorney General James Secures $4 Million from Companies Involved in Alleged Fraudulent Physical Therapy Scheme: Defendants Alleged to Have Had Non-licensed Individuals Provide Physical Therapy Services. Includes $2 Million to New York State Medicaid Program Alone
NEW YORK - New York Attorney General Letitia James today announced her office has secured $4 million from several physical therapy offices operated throughout New York City by Alex and Diana Klurfeld, and their companies Williamsburg Physical Therapy, P.C. and Euro Physical Therapy, P.C. (Williamsburg PT). Today's agreement resolves allegations that the couple and their companies falsely billed Medicaid and other federal health care programs for physical therapy services, as well as for having had non-licensed individuals provide physical therapy services.
Oct 2, 2020; Missouri Attorney General
St. Louis County Woman Pleads Guilty to Medicaid Fraud, Ordered to Pay $14,000 in Restitution
Missouri Attorney General Eric Schmitt announced that on September 9, 2020, Cherrine Shepperd pled guilty to the class D felony of Violations Involving Health Care Payments in the Circuit Court of St. Louis County.
October 2, 2020; South Carolina Attorney General
Marion City Council member charged with Medicaid fraud
(COLUMBIA, S.C.) - Attorney General Alan Wilson announces that Latashia (Tassie) Vasthi Lewis was charged on September 25th with Medical Assistance Provider Fraud. Lewis turned herself in that morning to the Alvin S. Glenn Detention Center in Richland County.
October 1, 2020; Tennessee Bureau of Investigation
Claiborne County Nurse Indicted on Prescription Fraud Charges
CLAIBORNE COUNTY - An investigation by Special Agents with the Tennessee Bureau of Investigation has led to the indictment of a Claiborne County nurse on forgery and prescription fraud charges.

September 2020

September 25th 2020; New York Attorney General
Attorney General James Delivers $22.7 Million in Busting Pharmaceutical Company for Its Kickback Scheme
NEW YORK - Attorney General Letitia James today announced that her office reached an agreement to settle kickback claims against Novartis Pharmaceuticals Corporation (Novartis) and delivered $22.7 million to New York.
September 25, 2020; Massachusetts Attorney General
AG Healey Announces Criminal Charges Against Superintendent and Former Medical Director of Holyoke Soldiers' Home for Their Roles in Deadly COVID-19 Outbreak: Bennett Walsh and David Clinton Face Criminal Neglect Charges in Connection with Outbreak that Contributed to the Death of 76 Veterans
Boston - Superintendent Bennett Walsh and former Medical Director David Clinton of the Soldiers' Home in Holyoke (SHH) have been indicted on criminal neglect charges for their roles in the deadly COVID-19 outbreak that contributed to the death of at least 76 residents at the facility, Attorney General Maura Healey announced today.
September 24, 2020; Indiana Attorney General
AG Curtis Hill announces $60M multistate settlement with maker of medical devices
Attorney General Curtis Hill today announced a settlement by Indiana, 47 other states and the District of Columbia with C.R. Bard Inc. and its parent company, Becton, Dickinson and Co., requiring payment of $60 million for the allegedly deceptive marketing of transvaginal surgical mesh devices. Under the settlement, Indiana receives just over $1.7 million.
September 23, 2020; Massachusetts Attorney General
North Chelmsford Pharmacy to Pay $500,000 to MassHealth over Claims of Operating an Automatic Refill Program
Boston - A pharmacy in North Chelmsford has agreed to pay $500,000 to resolve allegations that it improperly billed and received payments from the state's Medicaid Program (MassHealth) by operating an automatic refill program, Attorney General Maura Healey announced today.
September 23, 2020; New Jersey Attorney General
AG Grewal, Consumer Affairs Secure $1.66 Million Judgment Against Advanta Medicaid for Unfulfilled Promises to Assist Consumers in Establishing Medicaid Eligibility
NEWARK - Attorney General Gurbir S. Grewal and the Division of Consumer Affairs have obtained a Default Judgment against Ocean County-based Advanta Medicaid LLC d/b/a Advanta Medicaid Specialists ("Advanta"), and reached a settlement with one of the business's former owners in a civil lawsuit alleging that the company and its principals accepted hundreds of thousands of dollars from consumers after promising to assist them in establishing eligibility for Medicaid coverage and then failing to provide the promised services.
September 21, 2020; Indiana Attorney General
AG Hill announces $678M national settlement with Novartis Pharmaceuticals over alleged kickbacks
Attorney General Curtis Hill announced today that Indiana, along with 26 other states and the District of Columbia, has joined the federal government in reaching an agreement that settles allegations against Novartis Pharmaceuticals Corp.
September 18, 2020; Wisconsin Department of Justice
Sheboygan County Nurse Charged with Medical Assistance Fraud While Failing to Provide Care to Frail Toddler
ADELL, Wis. - Attorney General Josh Kaul announced today charges against Lori Kleinhans, 62, of Sheboygan County, in connection with alleged schemes to defraud Medicaid both as a provider and recipient of Medicaid benefits. The investigation was conducted by the Wisconsin Department of Justice (DOJ).
September 18, 2020; Florida Attorney General
Attorney General Moody Wins Big Tobacco Case Securing $90 Million for Florida and Millions More in Annual Payments
TALLAHASSEE, Fla.-Attorney General Ashley Moody today won a major court battle against big tobacco, securing millions for the state of Florida. The victory brings an end to years of litigation against R.J. Reynolds Tobacco Company over millions of dollars owed to the state through Florida's landmark tobacco settlement agreement.
September 17, 2020; Indiana Attorney General
AG Curtis Hill announces $4.2M settlement with pharmacy that allegedly paid kickbacks
Attorney General Curtis Hill today announced that Indiana has joined with other states and the federal government to reach an agreement with National Cornerstone Health Services (NCHS) to settle allegations that NCHS violated the False Claims Act.
September 17, 2020; California Attorney General
Attorney General Becerra Announces Landmark Settlement Against Glow, Inc. - Fertility App Risked Exposing Millions of Women's Personal and Medical Information
SACRAMENTO - California Attorney General Xavier Becerra today announced a landmark settlement against Glow, Inc. (Glow), a technology company that operates a fertility-tracking mobile app that stores personal and medical information. The settlement, which is subject to court approval, resolves the Attorney General's investigation of Glow's app for serious privacy and basic security failures that put women's highly-sensitive personal and medical information at risk.
September 15, 2020; Tennessee Bureau of Investigation
Morristown Woman Indicted, Accused of TennCare Fraud
HAMBLEN COUNTY - An investigation by Special Agents with the Tennessee Bureau of Investigation's Medicaid Fraud Control Division has resulted in the indictment of a Morristown woman on fraud charges.
September 15, 2020; State of Alaska Department of Law
Seth Lookhart Sentenced for Medical Assistance Fraud, Embezzlement, Reckless Endangerment, and Illegal Practice of Dentistry
(Anchorage, AK) -- The State of Alaska announces that yesterday Anchorage Superior Court Judge Michael Wolverton sentenced Dentist Seth Lookhart for defrauding the State of Alaska Medicaid system, Embezzlement, Reckless Endangerment, and the Illegal Practice of Dentistry.
September 15, 2020; Tennessee Bureau of Investigation
Morristown Woman Indicted, Accused of TennCare Fraud
HAMBLEN COUNTY - An investigation by Special Agents with the Tennessee Bureau of Investigation's Medicaid Fraud Control Division has resulted in the indictment of a Morristown woman on fraud charges.
September 15, 2020; Tennessee Bureau of Investigation
Caregivers Charged with Neglect of Vulnerable Adult
JACKSON - An investigation by Special Agents with the Tennessee Bureau of Investigation's Medicaid Fraud Control Division has resulted in the arrest of two caregivers who are charged with neglect of a patient.
September 14, 2020; Massachusetts Attorney General
Former Waltham Nursing Home Admissions Director Indicted in Connection with Embezzlement Scheme: Belmont Woman Allegedly Misappropriated More than $230,000 from Nursing Home Resident
Woburn - A former admissions director at the Meadow Green Nursing Home in Waltham has been indicted in connection with a scheme to steal hundreds of thousands of dollars from an elderly resident, Attorney General Maura Healey announced today.
September 14, 2020; California Attorney General
Attorney General Becerra Announces $11.8 Million Settlement Against Novartis Pharmaceuticals
SACRAMENTO - California Attorney General Xavier Becerra today announced an $11.8 million settlement against Novartis Pharmaceuticals Corporation (Novartis) related to allegations that the company engaged in a kickback scheme from January 2002 through November 2011 that impacted beneficiaries of Medicare and Medi-Cal.
September 11, 2020; Wisconsin Attorney General
Oshkosh Man Charged with Elder Abuse After Alleged Theft of $427,000 from Elderly Victim
OSHKOSH, Wis. - Attorney General Josh Kaul announced charges today against Terry Lynn Culver, 58, of Oshkosh in relation to the theft of over $427,000 from a 92-year-old resident of a nursing home. The charges are the result of a joint elder abuse and tax fraud investigation by the Wisconsin Department of Justice (DOJ) and Wisconsin Department of Revenue (DOR).
September 10, 2020; U.S. Attorney's Office, Eastern District of Virginia
Virginia Mental Health Agency Agrees to Pay $263,280 to Settle Civil False Claims Act Lawsuit
ALEXANDRIA, Va. - Victoria Transcultural Clinical Center, VTCC, LLC ("VTCC"), located in Fairfax, has agreed to pay $263,280 to settle a federal False Claims Act ("FCA") case pending in the United States District Court for the Eastern District of Virginia. VTCC provides mental health services and behavioral therapy to children and adolescents in northern Virginia who are Medicaid recipients.
September 9, 2020; North Carolina Attorney General
Attorney General Josh Stein Announces Triangle Medicaid Fraud Conviction
(RALEIGH) Attorney General Josh Stein today announced that Raleigh resident Patricia Weatherspoon Mosden pleaded guilty to fraud by a medical assistance provider and obtaining property by false pretenses in Robeson County Superior Court. She was sentenced to six to 17 months in prison and suspended for 24 months of supervised probation by Judge Franklin Floyd.
September 9, 2020; North Carolina Attorney General
Attorney General Josh Stein Reaches $900,000 Settlement with Owner and Managers of Carolina Comprehensive Health Network
(RALEIGH) Attorney General Josh Stein today reached a $900,000 settlement with two former managers, Michael Smith and Codey Brown, and the former owner, Dr. Harrison Frank, of the now-defunct Carolina Comprehensive Health Network PA (CCHN) to resolve allegations that they violated the False Claims Act and billed the Medicare and Medicaid programs for medically unnecessary diagnostic tests and procedures.
September 4, 2020; Tennessee Bureau of Investigation
Joint Investigation of Drugs, TennCare Fraud Results in Arrest of Weakley County Couple
WEAKLEY COUNTY - A joint investigation by Special Agents with the Drug Investigation Division of the Tennessee Bureau of Investigation and other state and local agencies has resulted in the arrest of a Dresden couple, on drug and TennCare fraud charges.
September 3, 2020; Pennsylvania Attorney General
Case Update: Lancaster Co. Psychiatrist Pleads Guilty to Illegally Prescribing Drugs
HARRISBURG - Attorney General Josh Shapiro today said the Lancaster County psychiatrist charged in June with illegally prescribing drugs to patients pleaded guilty to charges and will serve six months of house arrest, five years of probation, pay a $50,000 fine, have his Pennsylvania medical license suspended, and perform 50 hours of community service.

August 2020

August 31, 2020; Florida Attorney General
Behavior Analyst Arrested for Defrauding Medicaid Out of More Than $6,500
TALLAHASSEE, Fla.-Attorney General Ashley Moody's Medicaid Fraud Control Unit, with the assistance of the Polk County Sheriff's Office, today arrested a behavior analyst for defrauding the Medicaid program out of more than $6,500. Wendy Lynn Borden is employed by a Medicaid provider in Monroe County and provides behavior analyst services to Medicaid recipients. Borden is accused of falsifying progress notes and sign-in logs in order to be paid for services not rendered.
August 31, 2020; Tennessee Attorney General
Knoxville Woman Indicted on Identity Theft and TennCare Fraud Charges
CLAIBORNE COUNTY - An investigation by Special Agents with the Tennessee Bureau of Investigation's Medicaid Fraud Control Division and the Tazewell Police Department has resulted in the indictment of a Knoxville woman on fraud and identity theft charges.
August 26, 2020; Department of Justice, Commonwealth of Puerto Rico
Medicaid Fraud Control Unit Files Charges for Aggravated Illegal Appropriation of Medicaid Funds
(Spanish/Español)
(San Juan, Puerto Rico) - Acting Attorney General Inés del C. Carrau Martínez and the Medicaid Fraud Control Unit (MFCU) director, Special Prosecutor Rita Rodríguez-Falciani reported that charges were filed today against Maria J. Torres Torres, 48, a representative of Dental Health Care, LLC for Aggravated Misappropriation of funds belonging to the Medicaid Program and illegal practice of dentistry.
August 25, 2020; North Carolina Attorney General
Attorney General Josh Stein Takes Action to Protect NC Health Care Systems from PPE Price Gouging
(RALEIGH) Attorney General Josh Stein today announced that he is filing a lawsuit against Stephen Gould Corporation to enforce North Carolina's laws against price gouging during a state of emergency and against unfair and deceptive trade practices in connection with the COVID-19 pandemic. The lawsuit alleges that Stephen Gould Corporation pitched extremely high-priced N95 or similar face masks to the North Carolina Emergency Management Unit of the North Carolina Department of Public Safety, Duke Health, UNC Health, and the Charlotte Chapter of the American Red Cross.
August 19, 2020; Massachusetts Attorney General
AG Secures Settlements with Two Adult Day Health Centers over Allegations of Improper Billing
Boston - Attorney General Maura Healey announced today that two adult day health centers in Boston and Dartmouth will pay more than $186,000 to resolve allegations that they improperly billed the state's Medicaid Program (MassHealth).
August 17, 2020; Nevada Attorney General
Attorney General Ford Announces Sentencing of Owner of Las Vegas Medicaid Health Care Business
Las Vegas, NV - Today, Nevada Attorney General Aaron D. Ford announced that Keon Donnell Shavers, 43, of Las Vegas, the owner of Rays of Life Counseling Services (Rays of Life) was sentenced in a Medicaid fraud case involving false billing. The fraud occurred between January 2018 and July 2018.
August 17, 2020; Nevada Attorney General
Attorney General Ford Announces Sentencing of Owner of Las Vegas Medicaid Health Care Business
Las Vegas, NV - Today, Nevada Attorney General Aaron D. Ford announced that Keon Donnell Shavers, 43, of Las Vegas, the owner of Rays of Life Counseling Services (Rays of Life) was sentenced in a Medicaid fraud case involving false billing. The fraud occurred between January 2018 and July 2018.
August 11, 2020; Florida Attorney General
Attorney General Moody Announces New York Woman Arrested for Elder Exploitation of Florida Resident
TALLAHASSEE, Fla.-Attorney General Ashley Moody's Medicaid Fraud Control Unit, with the assistance of the Rotterdam New York Police Department, today arrested a Schenectady, New York woman for elder exploitation. Authorities arrested Amanda Shaw on one count of exploitation of an elderly person and one count of organized scheme to defraud for abusing a power of attorney to exploit almost $100,000 from a Deland resident. Shaw is a relative of the victim who resides in a Medicaid-funded facility in Florida.
August 11, 2020; Texas Attorney General
AG Paxton: Court Awards $16.5 Million to Texans in Medicaid Fraud Lawsuit
Attorney General Ken Paxton today announced that the 126th Judicial District Court of Travis County ordered final judgment against Dr. Richard Malouf, former owner of All Smiles Dental Center, holding him responsible for 1,842 unlawful acts under the Texas Medicaid Fraud Prevention Act and liable for approximately $16.5 million to the State of Texas.
August 11, 2020; Florida Attorney General
Attorney General Moody Announces New York Woman Arrested for Elder Exploitation of Florida Resident
TALLAHASSEE, Fla.—Attorney General Ashley Moody's Medicaid Fraud Control Unit, with the assistance of the Rotterdam New York Police Department, today arrested a Schenectady, New York woman for elder exploitation. Authorities arrested Amanda Shaw on one count of exploitation of an elderly person and one count of organized scheme to defraud for abusing a power of attorney to exploit almost $100,000 from a Deland resident. Shaw is a relative of the victim who resides in a Medicaid-funded facility in Florida.
August 11, 2020; Texas Attorney General
Court Awards $16.5 Million to Texans in Medicaid Fraud Lawsuit
Attorney General Ken Paxton today announced that the 126th Judicial District Court of Travis County ordered final judgment against Dr. Richard Malouf, former owner of All Smiles Dental Center, holding him responsible for 1,842 unlawful acts under the Texas Medicaid Fraud Prevention Act and liable for approximately $16.5 million to the State of Texas.
August 5, 2020; North Carolina Department of Justice
Attorney General Josh Stein Announces Health Care Fraud Conviction and Sentencing
(RALEIGH) Attorney General Josh Stein today announced that Lakeisha Shameika Jones pleaded guilty to fraud by a medical assistance provider and obtaining property by false pretenses. Jones was sentenced to eight to 19 months in prison and suspended for 36 months of supervised probation by Judge William Bland in Wayne County Superior Court.

July 2020

July 31, 2020; North Carolina Department of Justice
Attorney General Josh Stein Reaches Settlement over Pharma Company Kickback Allegations
RALEIGH- Attorney General Josh Stein today announced that he has reached a settlement over kickback violation allegations against Pacira Pharmaceuticals, Inc. ("Pacira"), a developer and manufacturer of pharmaceutical products based in Parsippany, New Jersey. Pursuant to the settlement terms, Pacira will pay $3,500,000.00, plus interest, to the United States and 15 states. As part of the settlement, North Carolina will receive $179,152.69 in restitution and other recoveries.
July 30, 2020; New York Attorney General
Attorney General James Secures $1.85 Million Following Medicaid Fraud by Global IT Company; Computer Sciences Corporation Used Statewide Children's Program to Misappropriate Taxpayer Funds
NEW YORK - New York Attorney General Letitia James reached an agreement with former multinational internet technology company, Computer Sciences Corporation (CSC), resulting in $1.85 million in recovered funds, with nearly $1 million earmarked for New York state.
July 29, 2020, Alabama Attorney General
Former Employee of Birmingham Area Psychology Clinic Pleads Guilty to Defrauding State Medicaid Agency by Filing False Claims for Counseling
(MONTGOMERY) -U.S. Attorney Prim Escalona for the Northern District of Alabama, Attorney General Steve Marshall and U.S. Department of Health and Human Services -OIG Special Agent in Charge Derrick Jackson, announced today the second conviction involving a former Birmingham area psychology clinic that defrauded the Alabama Medicaid Agency of at least $1.5 million by billing for counseling services that were never provided.
July 28, 2020; Arkansas Attorney General
Rutledge Announces Convictions of Booneville and Warren Men by the Medicaid Fraud Control Unit
LITTLE ROCK - Arkansas Attorney General Leslie Rutledge today announced the convictions of a Booneville man and a Warren man for separate physical abuse charges.
July 28, 2020; Wisconsin Attorney General
DOJ Prosecutors and DHS Recover Nearly $1 Million for Wisconsin Medicaid After Blood Clotting Medicine Overpayment to Providers
MADISON, Wis. - Attorney General Josh Kaul, and the Wisconsin Department of Health Services (DHS), today announced a recovery of $856,609.39 to the Wisconsin Medicaid program after three providers failed to comply with basic program requirements regarding the prescription and dispensing of blood clotting medicine.
July 28, 2020; North Carolina Attorney General
Attorney General Josh Stein Announces $49 Million Medicaid Fraud Settlement with Progenity
(RALEIGH) Attorney General Josh Stein today announced a $49 million multistate settlement and an agreement in principle with biotechnology company Progenity Inc., to resolve allegations that the company fraudulently billed federal health care programs for prenatal tests and provided kickbacks to physicians to encourage them to order Progenity tests for their patients. North Carolina will receive $50,292.24 of the settlement to resolve claims relating specifically to North Carolina's Medicaid program.
July 25, 2020; Tennessee Attorney General
Former Medical Staffing Business Owner Indicted on Multiple Charges
WILLIAMSON COUNTY - A multi-year investigation by Special Agents with the Medicaid Fraud Control Division of the Tennessee Bureau of Investigation has resulted in the indictment and arrest of a Pulaski woman on multiple counts, including TennCare fraud, forgery, and identity theft.
July 23, 2020; Florida Attorney General
Attorney General Moody Secures Millions for Florida Following a Multistate Health Care Investigation
TALLAHASSEE, Fla.-Attorney General Ashley Moody today announced that Florida will receive millions of dollars following a massive multistate health care fraud investigation. Florida, along with 49 states, territories and the federal government, settled allegations of fraud against Universal Health Services, Inc. UHS is a for-profit holding company that directly or indirectly owns the assets or stock of inpatient and residential psychiatric and behavioral health facilities that provide services to individuals, including beneficiaries of various federal health care programs, and UHS of Delaware, Inc., a subsidiary of UHS that provides management services to UHS and its subsidiaries.
July 23, 2020; Connecticut Attorney General
AG Tong Announces Settlement with Recovery Network of Programs Over Drug Testing Overbilling
(Hartford, CT) - Attorney General William Tong, U.S. Attorney John H. Durham, and Department of Social Services Commissioner Deidre S. Gifford today announced a $354,368 joint federal/state settlement with the Recovery Network of Programs (RNP) resolving overbilling for drug testing.
July 23, 2020; Florida Attorney General
Attorney General Moody Secures Millions for Florida Following a Multistate Health Care Investigation
TALLAHASSEE, Fla.-Attorney General Ashley Moody today announced that Florida will receive millions of dollars following a massive multistate health care fraud investigation. Florida, along with 49 states, territories and the federal government, settled allegations of fraud against Universal Health Services, Inc. UHS is a for-profit holding company that directly or indirectly owns the assets or stock of inpatient and residential psychiatric and behavioral health facilities that provide services to individuals, including beneficiaries of various federal health care programs, and UHS of Delaware, Inc., a subsidiary of UHS that provides management services to UHS and its subsidiaries.
July 23, 2020; Connecticut Attorney General
AG Tong Announces Settlement with Recovery Network of Programs Over Drug Testing Overbilling
(Hartford, CT) - Attorney General William Tong, U.S. Attorney John H. Durham, and Department of Social Services Commissioner Deidre S. Gifford today announced a $354,368 joint federal/state settlement with the Recovery Network of Programs (RNP) resolving overbilling for drug testing.
July 22, 2020; Nevada Attorney General
Attorney General Ford Settles Whistleblower Lawsuit Involving Behavioral Health Care Facilities
Carson City, NV - Today, Nevada Attorney General Aaron D. Ford announced that Nevada and 46 other states, territories and the federal government are settling allegations of fraud against Universal Health Services, Inc. (UHS). UHS is a for-profit holding company that directly or indirectly owns the assets or stock of inpatient and residential psychiatric and behavioral health facilities.
July 22, 2020; Nevada Attorney General
Attorney General Ford Settles Whistleblower Lawsuit Involving Behavioral Health Care Facilities
Carson City, NV - Today, Nevada Attorney General Aaron D. Ford announced that Nevada and 46 other states, territories and the federal government are settling allegations of fraud against Universal Health Services, Inc. (UHS). UHS is a for-profit holding company that directly or indirectly owns the assets or stock of inpatient and residential psychiatric and behavioral health facilities. These facilities provide health care services to individuals, including beneficiaries of some federal health care programs. The case also involved UHS of Delaware, Inc., a subsidiary of UHS, Inc., which provides management services to UHS and its subsidiaries.
July 22, 2020; North Carolina Attorney General
Attorney General Stein Announces Sentencing in $6.1 Million Medicaid Fraud Case
RALEIGH - Attorney General Josh Stein announced that Tony Garrett Taylor was sentenced to 96 months in prison followed by two years of supervised release by the United States District Court for the Western District of North Carolina for stealing more than $6.1 million from Medicaid and committing tax evasion. Taylor, a former resident of Harrisburg, was also ordered to pay $6,121,655 to North Carolina Medicaid and $1,124,603 to the U.S. Internal Revenue Service as restitution.
July 21, 2020; Massachusetts Attorney General
Montachusett Regional Transit Authority to Pay $300,000 to Resolve Allegations of Submitting False Claims to MassHealth: Settlement is the Result of a Joint Investigation with the U.S. Attorney's Office
Boston - Attorney General Maura Healey announced today that the Montachusett Regional Transit Authority (MART) will pay $300,000 to resolve allegations that it improperly caused false claims to be submitted to the state's Medicaid program (MassHealth).
July 21, 2020; Kentucky Attorney General
Attorney General Cameron Announces Conviction of a Hopkins County Nurse for Reckless Abuse of a Vulnerable Adult Investigation by Office of Medicaid Fraud and Abuse Leads to Conviction
FRANKFORT - Attorney General Daniel Cameron announced today that an investigation and prosecution by his Office of Medicaid Fraud and Abuse led to the conviction of Ashley Maypray, 36, of Madisonville, Kentucky, for reckless abuse of a vulnerable adult.
July 20, 2020; Kentucky Attorney General
Attorney General Cameron Announces Nearly $1 Million Settlement for Kentucky's Medicaid Program Resulting from Allegations Against Universal Health Services, Inc. and UHS of Delaware, Inc.
FRANKFORT - Attorney General Daniel Cameron announced today that Kentucky's Medicaid Program will receive $929,016.95 as part of a settlement regarding allegations of fraud against Universal Health Services, Inc. ("UHS, Inc."), a for-profit holding company, which directly or indirectly owns the assets or stock of inpatient and residential psychiatric and behavioral health facilities, and UHS of Delaware, Inc., a subsidiary of UHS, Inc., which provides management services to UHS, Inc. and its subsidiaries (collectively, "UHS").
July 17, 2020; Florida Attorney General
Capital City Health Care Provider Arrest for $50,000 in Medicaid Fraud
TALLAHASSEE, Fla.-Attorney General Ashley Moody's Medicaid Fraud Control Unit, with the assistance of the Leon County Sheriff's Office, today arrested a Medicaid provider on charges related to $50,000 in fraud. The arrest follows an MFCU investigation that revealed Rodney Burt, 57, billed the Florida Medicaid Program for services not rendered from May 2016 through November 2019.
July 16, 2020; Wisconsin Attorney General
Wisconsin Sues Pharmaceutical Company Alleging Company Knowingly Underpaid Hundreds of Millions of Dollars in Medicaid Rebates
MADISON, Wis. — Attorney General Josh Kaul, and the Wisconsin Department of Health Services (DHS), today announced that Wisconsin and 27 other states and territories sued Mallinckrodt ARD LLC, formerly known as Mallinckrodt ARD Inc. and previously Questcor Pharmaceuticals Inc. (collectively, Mallinckrodt), in the U.S. District Court for the District of Massachusetts. The complaint alleges that Mallinckrodt has violated the false claims acts by knowingly underpaying Medicaid rebates due as a result of large increases in the price of its drug H.P. Acthar Gel (Acthar).
July 14, 2020; Arkansas Attorney General
Rutledge Announces a Guilty Plea by the CEO and Owner of New Beginnings Behavioral Health Services: Says, 'This culture of corruption has run rampant through our Medicaid system and it must be stopped'
LITTLE ROCK - Arkansas Attorney General Leslie Rutledge today announced Chirie Bazzelle pleaded guilty to obstructing governmental operations. Bazzelle is the owner and CEO at New Beginnings Behavioral Health Services (New Beginnings). In 2018 alone, New Beginnings billed the Medicaid program over $5.3 million. As a result of this investigation and Bazzelle's arrest New Beginnings is no longer a Medicaid provider.
July 13, 2020; Arkansas Attorney General
Rutledge Announces Convictions of Conway and West Memphis Men by the Medicaid Fraud Control Unit
LITTLE ROCK - Arkansas Attorney General Leslie Rutledge today announced the convictions of a Conway man and a West Memphis man for separate abuse and Medicaid fraud charges.
July 13, 2020; Massachusetts Attorney General
Universal Health Services to Pay Massachusetts More than $15 Million to Resolve Whistleblower False Claims Cases
Boston — Attorney General Maura Healey announced today that Universal Health Services (UHS) will pay over $15 million to resolve two separate sets of allegations that the company improperly billed the state's Medicaid Program (MassHealth).
July 13, 2020; North Carolina Attorney General
Attorney General Josh Stein Reaches $117 Million Settlement with Universal Health Services
(RALEIGH) Attorney General Josh Stein today announced a $117 million settlement with Universal Health Services, Inc. (UHS, Inc.) and UHS of Delaware Inc. to settle allegations of conduct violating the Federal False Claims Act and the North Carolina False Claims Act and resulting in the submission of false claims to the North Carolina Medicaid program. UHS, Inc. is a for-profit holding company that owns assets or stocks of inpatient and residential psychiatric and behavioral health facilities, and together with its subsidiaries is one of the nation's largest providers of hospital and health care services. The North Carolina Medicaid program will receive $3,131,988.14 from the settlement, which includes 47 other states, territories, and the federal government.
July 13, 2020; California Attorney General
Attorney General Becerra Announces $1 Million Settlement Against Nursing Facility for Medi-Cal Fraud: Public Encouraged to Report Elder Abuse and Medi-Cal Fraud to BMFEA's Hotline (800) 722 0432 or www.oag.ca.gov
SACRAMENTO — California Attorney General Xavier Becerra today announced a $1 million settlement against the owner and operator of Legacy Post-Acute Rehabilitation Center (Legacy), a skilled nursing facility in San Bernardino, for alleged violations of the California False Claims Act. The settlement resolves allegations that Legacy wrongfully billed Medi-Cal for patients needing a heightened level of skilled nursing care known as subacute care, specifically by failing to provide the minimum number of nursing hours for subacute care and assigning subacute patients to non-subacute beds.
July 6, 2020; Florida Attorney General
Certified Nursing Assistant Arrested for Exploitation of a Disabled Adult
TALLAHASSEE, Fla.-Attorney General Ashley Moody today announced an arrest by the Winter Haven Police Department of a Polk County licensed certified nursing assistant for exploitation of a disabled adult. The arrest follows an investigation by Attorney General Moody's Medicaid Fraud Control Unit that revealed Jacqueline Bing financially exploited a disabled adult and Medicaid recipient by remaining as the Social Security representative payee after the vulnerable adult left Bing's care.
July 3, 2020; Massachusetts Attorney General
Newton Transportation Company Resolves Claims of Improperly Billing MassHealth for Wheelchair Van Rides: Provider Used Uber and Lyft to Transport Patients; Will be Permanently Barred from Participating in MassHealth
Boston - A Newton transportation company and its owner will pay more than $27,000 and will be permanently excluded from being MassHealth providers to resolve allegations of improperly billing the state's Medicaid Program (MassHealth) for wheelchair van rides when it actually was using ride share services, Attorney General Maura Healey announced today.

June 2020

June 24, 2020; Florida Attorney General
Home and Community-Based Services Business Owner Arrested for Defrauding Medicaid Out of More Than $200,000
TALLAHASSEE, Fla.-Attorney General Ashley Moody's Medicaid Fraud Control Unit and the St. Lucie County Sheriff's Office, along with the U.S. Marshall Fugitive Task Force, today arrested a home and community-based services business owner for defrauding the Medicaid program out of more than $200,000.
June 23, 2020; Nevada Attorney General
Attorney General Ford Announces Sentencing of Former Co-Owners of Reno-Based Medicaid Provider Lifetime Assistance LLC
Carson City, NV - Nevada Attorney General Aaron D. Ford announced that Ariell Dix, 33, of Chandler, Arizona and Nneka Gibney, 60, of Sparks, Nevada, were sentenced in a fraud case involving the failure to maintain adequate records to substantiate claims submitted to Nevada Medicaid between July 1, 2017 and January 31, 2018.
June 22, 2020; Nevada Attorney General
Attorney General Ford Announces Sentencing of Las Vegas Medicaid Provider Brandy Latoya Williams
Las Vegas, NV - Today, Nevada Attorney General Aaron D. Ford announced that Brandy Latoya Williams, 34, of Las Vegas, was sentenced in a Medicaid fraud case involving false billing for Medicaid services allegedly provided to Medicaid recipients. The fraud occurred between January 2015 and February 2017.
June 22, 2020; Pennsylvania Attorney General
AG Shapiro and 45th Statewide Grand Jury: Lancaster Doctor Charged With Unlawful Prescribing, Medicaid Fraud
HARRISBURG—Attorney General Josh Shapiro today announced that the 45th Statewide Investigating Grand Jury voted to charge Bassam El-Borno, M.D., a Lancaster County psychiatrist with felony violations of the Drug Act for prescribing outside the good faith practice of medicine, Medicaid fraud, theft by deception, insurance fraud, and a violation of the Wiretap Act.
June 22, 2020; Nevada Attorney General
Attorney General Ford Announces Sentencing of Las Vegas Medicaid Provider Brandy Latoya Williams
Las Vegas, NV - Today, Nevada Attorney General Aaron D. Ford announced that Brandy Latoya Williams, 34, of Las Vegas, was sentenced in a Medicaid fraud case involving false billing for Medicaid services allegedly provided to Medicaid recipients. The fraud occurred between January 2015 and February 2017.
June 15, 2020; Nevada Attorney General
Attorney General Ford Announces Sentencing of Former Medicaid Provider Business Owner Darryl John Allen
Las Vegas, NV - Today, Nevada Attorney General Aaron D. Ford announced that Darryl John Allen, 52, of Las Vegas, was sentenced in a Medicaid fraud case involving submitting false claims to Nevada Medicaid. The fraud occurred between January 2016 and May 2017.

May 2020

May 27, 2020; Florida Office of the Attorney General
Pinellas County Resident Arrested for Medicaid Provider Fraud
TALLAHASSEE, Fla.-Attorney General Ashley Moody's Medicaid Fraud Control Unit and the St. Petersburg Police Department today arrested a Pinellas County man for willfully and intentionally engaging in Medicaid fraud for more than two years. Willie T. Barnes allegedly received more than $15,000 in Medicaid payments for therapy never provided to clients. Barnes is the owner and operator of Barnes Holistic Counseling Therapies Institute located in St. Petersburg.
May 21, 2020; Florida Office of the Attorney General
Caregiver Arrested for Neglect of an Elderly Adult
TALLAHASSEE, Fla.-Attorney General Ashley Moody's Medicaid Fraud Control Unit and the Okaloosa County Sheriff's Office today announced the arrest of a Fort Walton Beach woman for neglecting an elderly adult for more than a month. While employed at Destin Healthcare and Rehabilitation Center, Deanna Kay Tobin oversaw the care of pressure wounds by nurses and staff under her supervision. Tobin, charged with tending to elderly patients, failed to do so, and authorities arrested her on Wednesday.
May 14, 2020; Attorney General of Texas
Court Awards Millions for Texans in Medicaid Fraud Lawsuit
Attorney General Ken Paxton today announced that the Hon. Catherine Mauzy of the 126th Judicial District Court of Travis County has ruled Dr. Richard Malouf of ASDC Holdings, LLC responsible for 1,842 unlawful acts under the Texas Medicaid Fraud Prevention Act. Dr. Malouf operated orthodontics clinics for many years in the Dallas area and billed tens of millions of dollars to Texas Medicaid. The Court found that Malouf fraudulently billed Medicaid for services that were actually provided by a different doctor, including over 100 billings he filed while vacationing out of the country.
May 12, 2020; Pennsylvania Office of Attorney General
AG Shapiro: We Are Investigating Pennsylvania Nursing Homes For Criminal Neglect
HARRISBURG, PA - Today, Attorney General Shapiro announced that over the past several weeks his office opened criminal investigations into several Pennsylvania nursing homes and reaffirmed that the Office of Attorney General will investigate any nursing home engaging in criminal neglect of patients and residents. While the Pennsylvania Department of Health has primary regulating and licensing authority of nursing homes throughout the Commonwealth, the Attorney General's Care-Dependent Neglect Team, within the Medicaid Fraud Control Section, has jurisdiction on matters of criminal neglect.
May 7, 2020; U.S. Attorney's Office, Southern District of Texas
Texas man admits role in nearly $5 million health care fraud scheme
CORPUS CHRISTI, Texas - A 57-year-old Houston man has entered a guilty plea in Corpus Christi federal court for conspiring to commit health care fraud, announced U.S. Attorney Ryan Patrick.
May 6, 2020; Office of the Attorney General of Connecticut
Connecticut Announces Joint State-Federal COVID-19 Fraud Task Force
(Hartford, CT) - Attorney General William Tong, U.S. Attorney John Durham, the Federal Bureau of Investigation, and Chief State's Attorney Richard Colangelo announced formation of a joint federal-state task force combatting COVID-19 related fraud in Connecticut. The task force will investigate and prosecute a wide range of misconduct related to the COVID-19 pandemic, including price gouging, healthcare and government program fraud, consumer and small business scams, lending scams, charities fraud, and cyber fraud. Violators may be subject to civil fines and penalties and/or state or federal criminal prosecution.
May 4, 2020; Florida Office of the Attorney General
Pasco County Resident Arrested for Identity Theft and Exploitation of an Elderly Person or Disabled Adult
TALLAHASSEE, Fla.-Attorney General Ashley Moody's Medicaid Fraud Control Unit and the Tarpon Springs Police Department today arrested a Pasco County resident for exploiting two seniors under the defendant's care. Ronald Rose, Jr., 48, withdrew thousands of dollars from the relatives' bank accounts without approval to spend on personal expenses such as rent, vehicle payments and phone services.

April 2020

April 30, 2020; Florida Office of the Attorney General
Medical Companies Agree to Pay Florida Medicaid More Than $500,000 to Settle False Claim Act Allegations
TALLAHASSEE, Fla.-Attorney General Ashley Moody today announced that Florida, along with Colorado, Georgia, North Carolina, Virginia and the federal government, have reached an agreement with Logan Laboratories LLC and Tampa Pain Relief Centers, Inc. to resolve allegations that companies billed government health care programs for unnecessary medical laboratory tests. As part of the agreement, Logan Labs, Tampa Pain, and two former executives will pay $535,449 for submitting or causing the submission of false claims to the Florida Medicaid program.
April 29, 2020; North Carolina Department of Justice
Attorney General Josh Stein Announces $8.8 Million Medicaid Fraud Settlement with Dunn Physician
(RALEIGH) Attorney General Josh Stein today announced an $8.8 million dollar settlement with Dr. Ibrahim Oudeh, his wife Teresa Sloan-Oudeh, and his medical practice over allegations of Medicaid fraud. Dr. Oudeh, Mrs. Sloan-Oudeh, and the medical practice agreed to relinquish assets valued at approximately $3,300,000 and further agreed to a conditional consent judgment of $5,500,000 to settle civil False Claims Act liability for allegedly false Medicare and Medicaid claims.
April 24, 2020; Massachusetts Office of Attorney General
Avon-based Home Health Company to Pay $450,000 to Resolve Allegations of False Medicaid Billing
BOSTON - An Avon home health agency will pay $450,000 to resolve allegations that it submitted false claims to the state's Medicaid program (MassHealth), Attorney General Maura Healey announced today.
April 13, 2020; North Dakota Attorney General's Office
State's New Medicaid Fraud Unit Prosecutes First Case
BISMARCK, ND - The state's new Medicaid Fraud Control Unit has filed charges to begin prosecution of its first case, announced Attorney General Wayne Stenehjem. In January 2020, the Pembina County Sheriff's Office contacted the Medicaid Fraud Control Unit (MFCU) regarding an ongoing investigation into alleged theft of narcotics at a long-term care facility. The MFCU concluded the investigation, and Director Marina Spahr has filed felony charges in Pembina County District Court against Charlotte Kay Reilly, age 32, of Crystal, North Dakota, for theft of prescription medication and reckless endangerment.

March 2020

March 9, 2020; Florida Office of the Attorney General
Central Florida Woman Arrested for Fraudulently Billing More Than $49,000 to Medicaid
TALLAHASSEE, Fla.-Attorney General Ashley Moody today announced the arrest of an individual on charges of Medicaid provider fraud. Teresa B. Moore is accused of engaging in a systematic scheme to fraudulently bill the Medicaid system, including billing for services not rendered and submitting false claims of approximately $49,500. The Orleans Parish Sheriff's Office arrested Moore in Louisiana and will extradite Moore back to Florida.
March 5, 2020; State of Georgia Office of the Attorney General
Carr Announces Guilty Pleas in Three Medicaid Fraud Cases
ATLANTA, GA - Attorney General Chris Carr today announced Quanicia Wilson, Shuconda Tinsley and Denise McBride entered guilty pleas to Medicaid Fraud and other crimes. These cases combined will result in restitution of over $122,000.00 to Medicaid and a total of 30 years of probation or prison time for the Defendants.
March 4, 2020; U.S. Attorney's Office, Eastern District of Pennsylvania
Three Delaware County Residents Charged in $320k Medicaid Fraud Scheme
HARRISBURG-Pennsylvania Attorney General Josh Shapiro today announced the arrests of three Delaware County residents for fraudulently billing the Pennsylvania Medical Assistance program for more than $320,000 worth of direct care services that did not occur.
March 4, 2020; USAO Northern District of Georgia and Georgia State Attorney General
Georgia Medicaid Provider and Senior Executives Agree to Pay $1.75 Million to Resolve False Claims Allegations
ATLANTA, GA - Attorney General Chris Carr, U.S. Attorney for the Northern District of Georgia BJay Pak and partners today announced that STG Healthcare of Atlanta, Inc. ("STG Healthcare") and CEO Paschal "Pat" Gilley and CFO Matthew Gilley have agreed to pay 1.75 million to settle allegations involving false claims submitted to Medicare and the Georgia Medicaid program. The Medicaid portion of the settlement is approximately $607,682.
March 2, 2020; State of Connecticut Attorney General
Connecticut Announces $4.9 Million State/Federal False Claims Settlement with Middletown Doctor Couple
(Hartford, CT) -Attorney General William Tong, U.S. Attorney John H. Durham, Comptroller Kevin Lembo and Connecticut Department of Social Services Commissioner Deidre S. Gifford announced today that Connecticut has reached a $4.9 million civil False Claims Act settlement with Middletown couple Crispin and Antonieta Abarientos regarding a long-term fraudulent medical billing scheme involving costly infusions. This is the first False Claims settlement to date regarding the Connecticut State Health Plan.
March 2, 2020; U.S. Attorney's Office, Western District of Texas
Former Adult Day Care Activity Center Owner in San Antonio Pleads Guilty to Health Care Fraud Scheme and Theft of Social Security Benefits
In San Antonio today, 52-year-old Scherry Lynn Moses pleaded guilty federal charges in connection with a scheme that fraudulently billed Medicaid for services not rendered and for stealing benefits from Social Security recipients, announced U.S. Attorney John F. Bash.

February 2020

February 19, 2020; Office of Massachusetts Attorney General Maura Healey
Canton Doctor Settles Allegations of Illegal Patient Kickback Schemes
A Canton dentist and his practice will pay $135,000 to resolve allegations that they were running an illegal kickback scheme that led to improper payments from the state's Medicaid Program (MassHealth), Attorney General Maura Healey announced today.
February 3, 2020; Tennessee Department of Finance & Administration
Marshall Co. Woman Charged with TennCare Fraud
NASHVILLE, Tenn. - A Marshall County woman is charged with TennCare fraud involving doctor shopping for drugs, which is the practice of visiting multiple physicians in a 30-day window to obtain multiple prescriptions for otherwise illegal drugs.

January 2020

January 24, 2020; Tennessee Department of Finance and Administration
Lincoln Co. Woman Charged with TennCare Fraud
NASHVILLE, Tenn. - A Lincoln County woman is charged with TennCare drug fraud in connection with allegedly selling drugs obtained through TennCare healthcare insurance benefits.
January 10, 2020; Tennessee Department of Finance and Administration
Two People in Madison County Charged with TennCare Fraud
NASHVILLE, Tenn. - Two people in Madison County are charged with TennCare fraud in related cases. The arrests involve a person allegedly accessing the benefits of a member of TennCare CHOICES, a program that offers nursing facility services and home and community-based services for seniors and for adults with a physical disability.
January 8, 2020; Michigan Attorney General
Nessel Charges Owner of Saginaw Treatment Center with Fraud
LANSING- Michigan Attorney General Dana Nessel today announced that 20 felony counts of Medicaid Fraud were filed Monday against Steven Clark, president and owner of EDM Treatment Center in Saginaw, Michigan.

December 2019

December 17, 2019; Tennessee Department of Finance and Administration
Brownsville Woman Charged with TennCare Fraud
NASHVILLE, Tenn. - A woman from Brownsville, Tenn., is charged with TennCare fraud and identity theft for allowing another person to use her TennCare card to receive dental benefits.
December 9, 2019; Nevada Attorney General
Attorney General Ford Announces Sentencing of Las Vegas Medicaid Health Care Providers
Las Vegas, NV - Today, Nevada Attorney General Aaron D. Ford announced that Jason Andre Pearson, 29, of Las Vegas, and Emerald Vision Services, LLC (Emerald Vision) were sentenced in a Medicaid fraud case involving false billing. The fraud occurred between July 2017 and May 2018.

November 2019

November 27, 2019; Florida Attorney General
Orange County Women Arrested for Aggravated Abuse of Mentally Disabled Adult
TALLAHASSEE, Fla.-Attorney General Ashley Moody today announced the arrest of an individual who allegedly abused a mentally disabled adult. Following an investigation by the Attorney General's Medicaid Fraud Control Unit, the Orange County Sheriff's Office today arrested Juliet Haimes on one count of aggravated abuse of a mentally disabled person. The investigation found that Haimes, a former employee at the LaMirada group home in Winter Springs, maliciously punished a mentally disabled adult under Haimes' care.
November 22, 2019; Tennessee Department of Finance and Administration
Morgan Co. Man Charged with TennCare Drug Fraud
Nashville, Tenn. - A Morgan County man is charged with TennCare fraud in an indictment accusing him of selling prescription painkillers paid for with TennCare benefits.
November 22, 2019; Tennessee Department of Finance and Administration
Morgan Co. Man Charged with TennCare Drug Fraud
Nashville, Tenn. - A Morgan County man is charged with TennCare fraud in an indictment accusing him of selling prescription painkillers paid for with TennCare benefits.
November 21, 2019; Tennessee Department of Finance and Administration
Shelby Co. Woman Charged with TennCare Fraud
Nashville, Tenn. - A Shelby County woman is charged with TennCare fraud and theft of property in connection with fraudulently enrolling in the state's healthcare insurance program.
November 21, 2019; Tennessee Department of Finance and Administration
Shelby Co. Woman Charged with TennCare Fraud
Nashville, Tenn. - A Shelby County woman is charged with TennCare fraud and theft of property in connection with fraudulently enrolling in the state's healthcare insurance program.
November 20, 2019; Arkansas Attorney General
Benton Business Owner Convicted of Medicaid Fraud
LITTLE ROCK - Arkansas Attorney General Leslie Rutledge today announced the conviction of a Benton business owner who fraudulently billed Medicaid more than $64,000 for speech therapy services at a daycare for children who did not attend the daycare and/or did not need speech therapy.
November 15, 2019; Texas Attorney General
AG Paxton Recovers $63.5 Million for State of Texas, U.S. Medicaid Program
Texas Attorney General Ken Paxton today resolved an enforcement action against pharmaceutical product manufacturer Lupin Limited, Lupin Inc. and Lupin Pharmaceuticals, Inc., and its Chief Executive Officer Vinita Gupta and Executive Vice President, US Generics Robert Hoffman. The agreement resolves the state's lawsuit under the Texas Medicaid Fraud Prevention Act (TMFPA) against Lupin for reporting inflated drug prices to the Medicaid program. Under the agreement, Lupin will pay more than $63 million to Texas and the federal government to resolve the claims against it.
November 19, 2019; New York Attorney General
Attorney General James Announces $500,000 Settlement With Kaleida Health Following Investigation Of Infant's Death
BUFFALO - New York Attorney General Letitia James today announced a settlement with Kaleida Health, the largest not-for-profit health care provider in Western New York, to resolve an investigation into the death of a 16-month-old pediatric resident in 2015, as well as the previous arrests of 17 caregivers in 2014, who were subsequently convicted of neglect of a resident with Huntington's disease at the HighPointe on Michigan Health Care Facility in Buffalo.

October 2019

October 23, 2019; Kentucky Attorney General
Beshear Recovers $22.7 Million in Medicaid Dollars after Settlement with Suboxone Distributor
FRANKFORT, KY. (Oct. 23, 2019) - Attorney General Andy Beshear announced today that his office has recovered $22.7 million in state and federal Medicaid dollars after reaching an agreement with a pharmaceutical distributor over its improper marketing and promotion of the drug Suboxone.
October 25, 2019; Florida Attorney General
Woman Arrested for Exploiting Senior in Bradford County
TALLAHASSEE, Fla.-Attorney General Ashley Moody's Medicaid Fraud Control Unit, in conjunction with the Starke Police Department, today arrested a woman for exploitation of an elderly person in Bradford County. Following a MFCU investigation, SPD brought Shantel Guion, a former employee at a skilled nursing center, into custody for allegedly exploiting personal funds from a resident at the facility where Guion worked.
October 25, 2019; Missouri Attorney General
AG Schmitt Secures $1.4 Million for Missouri in Medicaid Fraud Settlement
Jefferson City, Mo. - Today, Missouri Attorney General Eric Schmitt, along with several other states, announced a multi-state settlement with pharmaceutical distributor Reckitt Benckiser for improperly marketing and otherwise promoting the drug Suboxone, resulting in improper expenditures of state Medicaid funds. Missouri's share of the settlement is $4,354,401.58 federal and state combined with $1,458,823.01 directly to the State.
October 23, 2019; Arkansas Attorney General
Suspect admitted to knowingly submitting illegal Medicaid claims
LITTLE ROCK - Arkansas Attorney General Leslie Rutledge today announced the charge and arrest of a Conway eye doctor's employee for stealing an estimated $600,000 from the Arkansas Medicaid Program over a four-year period.
October 24, 2019; Massachusetts Attorney General
Transportation Company Owner Pleads Guilty to Multi-Million Dollar Medicaid Fraud Scheme
Worcester - The owner of a transportation company has pleaded guilty to charges in connection with fraudulently billing millions in false claims to the state's Medicaid Program (MassHealth), Attorney General Maura Healey announced today.
October 21, 2019; Indiana Attorney General
MFCU investigation leads to jail time in Medicaid fraud case
A Marion County Superior Court, pursuant to a plea agreement, has sentenced a nurse to three years following her conviction on multiple counts of forgery. The defendant, Mia Merriweather, was taken into custody at her Oct. 15 sentencing to serve 60 of those days in jail. Merriweather was also ordered to pay $7,956.25 in restitution to the Indiana Medicaid Program during her probation.
October 17, 2019; North Carolina Attorney General
Attorney General Josh Stein Announces Health Care Fraud Conviction
(RALEIGH) Attorney General Josh Stein today announced that behavioral health services company owner Pamela Grace Faulkner pleaded guilty to one count of conspiracy to commit health care fraud in the Eastern District of North Carolina.
October 4, 2019; Missouri Attorney General
Jackson County Licensed Professional Counselor Pleads Guilty to Medicaid Fraud
Jefferson City, Mo. - Missouri Attorney General Eric Schmitt announced that Donna Dixon has pled guilty to one count of the class C felony of Medicaid Fraud in the Circuit Court of Jackson County.
October 1, 2019; Tennessee Department of Finance and Administration
North Carolina Woman Charged with TennCare Fraud
NASHVILLE, Tenn. - A North Carolina woman is charged with TennCare fraud and theft of services for misrepresenting her circumstances in order to qualify for the state's healthcare insurance program.

August 2019

September 25, 2019; Florida Attorney General
Attorney General Moody�s Medicaid Fraud Control Unit Arrests 19 in Regional Takedown
TALLAHASSEE, Fla.�Attorney General Ashley Moody today announced the completion of a statewide Medicaid fraud takedown. The Attorney General�s Medicaid Fraud Control Unit executed 19 arrests for fraudulently billing Medicaid more than a million dollars. The arrests culminated from 14 different cases covering a wide range of charges, including: aggravated identity theft, conspiracy to commit health care fraud, exploitation involving an elderly person, false statements in connection with a health care matter, practicing as a health care professional without a valid license and more.
September 17, 2019; New York Attorney General
NYC Transportation Company Owner And Driver Arrested For Defrauding Medicaid Of Over $1 Million
NEW YORK - Attorney General Letitia James today announced the indictment and arrest of the owner of Purple Heart Transportation ("Purple Heart"), Sean Ally, 44, as well as the indictment and arrest of a driver of the company, Lissette Joza, 31, for stealing over $1 million from the New York Medicaid program for billing fake transportation services that were never provided. Ally and Joza were arrested late Friday night upon their arrival at JFK airport from Guyana. Both defendants as well as a third indicted defendant, Shamiza Ally, fled the United States some months earlier. Shamiza Ally, the third indicted defendant, remains at large abroad.
September 5, 2019; North Carolina Attorney General
Attorney General Josh Stein Announces Operation Root Canal Settlement With Durham Dentist Over Medicaid Fraud
(RALEIGH) Attorney General Josh Stein today announced that he has reached a $375,000 settlement with Santa Maria McKibbins, D.D.S., and her dental practice, Santa McKibbins Family Dentistry, to resolve allegations involving the submission of false claims to the North Carolina Medicaid program. Today's action is part of the NCDOJ Medicaid Investigation Division's ongoing Operation Root Canal effort to find and stop fraud among dental providers.
August 28, 2019; Florida Attorney General
Attorney General's Medicaid Fraud Control Unit Arrests Crestview Woman for Abuse of Disabled Adult
TALLAHASSEE, Fla.-Attorney General Ashley Moody today announced the arrest of a Crestview woman for abuse of a disabled woman. Tuesday, the Attorney General's Medicaid Fraud Control Unit and the Okaloosa County Sheriff's Office arrested Angelia Maddox. The arrest followed an investigation by Attorney General Moody's MFCU.
August 26, 2019; Tennessee Department of Finance and Administration
Henderson Co. Woman Charged 3rd Time with TennCare Fraud
NASHVILLE, Tenn. - A Henderson County woman has been charged for the third time with doctor shopping for controlled substances, using TennCare as payment.
August 22, 2019; Florida Attorney General
Attorney General Moody's Medicaid Fraud Control Unit Arrests Viera Woman for Medicaid Fraud
TALLAHASSEE, Fla.-Attorney General Ashley Moody's Medicaid Fraud Control Unit and the Brevard County Sheriff's Office arrested an individual on charges of Medicaid provider fraud. Laura Leace is accused of engaging in a systematic scheme to fraudulently bill the Medicaid system, including billing for services not rendered and submitting false claims totaling more than $45,000.
August 19, 2019; Kentucky Attorney General
Beshear: Marshall County Grand Jury Indicts Couple on Medicaid Fraud Charges
FRANKFORT, Ky. (Aug. 19, 2019) - Attorney General Andy Beshear and his Office of Medicaid Fraud and Abuse Control announced today that a Marshall County grand jury indicted a couple on Medicaid fraud charges.
August 19, 2019; Maryland Attorney General
Baltimore City Woman Sentenced for Medicaid Fraud
Maryland Attorney General Brian E. Frosh announced today that Mariah Larease Moore, 25, was convicted of felony Medicaid fraud related to the purported care of her grandmother. Anne Arundel County Circuit Court Judge Laura S. Ripken sentenced Moore to one year incarceration, all suspended, placed her on three years probation, and ordered more than $29,000 in restitution to the Medicaid program.
August 16, 2019; North Carolina Attorney General
Attorney General Josh Stein Announces Corporate Health Care Fraud Sentencing
(RALEIGH) Attorney General Josh Stein today announced that Gate City Transportation Inc., a Greensboro-based medical transport company, was sentenced in the Middle District of North Carolina after pleading guilty to one count of health care fraud in October 2018. The company was ordered to pay a $100 fine, a $400 special assessment, and restitution in the amount of $5,245,640.02 to the N.C. Fund for Medical Assistance.
August 15, 2019; Alabama Attorney General
Birmingham Psychologist Agrees to Plead Guilty to Defrauding State Medicaid Agency of $1.5 Million by Filing False Claims for Counseling
BIRMINGHAM- A one-count information filed yesterday in U.S. District Court charges a Birmingham psychologist with defrauding the Alabama Medicaid Agency by filing false claims for counseling services that were not provided, announced Alabama Attorney General Steve Marshall, U.S. Attorney Jay E. Town and U.S. Department of Health and Human Services-OIG Special Agent in Charge Derrick Jackson.
August 14, 2019; Tennessee Department of Finance and Administration
Hancock Co. Man Charged with TennCare Drug Fraud
NASHVILLE, Tenn. - A Hancock County man is charged with TennCare fraud in connection with selling prescription drugs he obtained using TennCare benefits.
August 8, 2019; Florida Attorney General
Attorney General's Medicaid Fraud Control Unit Arrests Individuals in Senior Exploitation Sweep
TALLAHASSEE, Fla.-Attorney General Ashley Moody's Medicaid Fraud Control Unit conducted an exploitation sweep this week that resulted in the arrest of four individuals who exploited seniors and disabled individuals. The sweep involved three separate investigations based on referrals from the Florida Department of Children and Families Adult Protective Services. All defendants used exploited funds for personal benefit, ranging from a down payment on a house to cruise and airline tickets. Authorities arrested the following individuals as a result of the Attorney General's sweep: Alex Bellamy, Kalonya Bellamy, Willie Mote, Jr., and Robin Stapleton.
August 2, 2019; Tennessee Department of Finance and Administration
McMinn Co. Woman Charged with TennCare Drug Fraud
NASHVILLE, Tenn. - A McMinn County woman is charged with TennCare fraud in connection with selling prescription drugs she obtained using TennCare benefits.

July 2019

July 24, 2019; Florida Attorney General
Owner of South Florida Sober Homes Arrested on Multiple Counts of Patient Brokering and Felony Money Laundering
TALLAHASSEE, Fla.-Attorney General Ashley Moody's Office of Statewide Prosecution, Florida Department of Law Enforcement, Palm Beach County State Attorney's Office and the Palm Beach County Sheriff's Office arrested a Dade County resident for multiple counts of patient brokering and felony money laundering. Adam Adler directed South Florida addiction treatment facilities and sober homes that he owned to send patients' urine for urinalysis testing in exchange for more than $1 million in kickbacks.
July 23, 2019; Arkansas Attorney General
Rutledge's Statement Following Warren Dentist Guilty Plea
LITTLE ROCK - Arkansas Attorney General Leslie Rutledge announces Dr. John Durmon, 59, of Warren, pleaded guilty to one count of Medicaid Fraud, class A felony. He has been ordered to pay $33,383.05 in restitution along with a triple penalty of $100,149.15 by Monday, July 29. He also owes fines and court costs of $2,500 and is suspended from the Medicaid program for five years.
July 12, 2019; Tennessee Department of Finance and Administration
Three Shelby Co. Residents Charged with TennCare Fraud
NASHVILLE, Tenn. - - Three Shelby County residents are each charged in separate cases with TennCare fraud. The Office of Inspector General (OIG), with the assistance of the Shelby County Sheriff's Office, today announced the arrests.
July 1, 2019; New York Attorney General
Attorney General James Announces Arrests Of Assisted Living Facility Employees For Putting Elderly Resident In Harm's Way
BUFFALO - Attorney General Letitia James today announced the arrests and arraignments of personal care assistants George Stokes, LaQuanda Johnson and Caprice Newbern, as well as medical technician Stephanie Shinault, in the Town of Amherst Court for allegedly abandoning the care of a vulnerable elderly resident at the Brompton Heights assisted living facility. The resident wandered out of the facility and was found after remaining outdoors for hours in freezing temperatures on the night of December 8-9, 2017. Stokes was arrested and arraigned on June 27, 2019, and Shinault, Johnson and Newbern were arrested and arraigned on June 12, 2019.

June 2019

June 24, 2019; Georgia Attorney General
Beshear: Former Somerset Caregiver Pleads Guilty to Abusing, Neglecting Adult
FRANKFORT, KY. (June 24, 2019) - Attorney General Andy Beshear and his Office of Medicaid Fraud and Abuse today announced the guilty plea of a Pulaski County woman on one count of knowingly abusing or neglecting an adult, a Class C felony.
June 24, 2019; Georgia Attorney General
Rutledge Lauds Prison Sentence of Helena-West Helena Hospice Owner
LITTLE ROCK - Arkansas Attorney General Leslie Rutledge released the following statement on the decision sentencing Charline Brandon to five years in prison. Brandon, owner of Bridge of Faith Hospice & Palliative Care of Helena-West Helena, pleaded guilty to two counts of Medicaid fraud and one count of willful failure to pay or file taxes.
June 21, 2019; Tennessee Department of Finance and Administration
Sixth Person in Alabama Charged with TennCare Fraud
NASHVILLE, Tenn. - An Alabama woman is the sixth person in the last month to be charged in Marion County with TennCare fraud for falsely reporting her residence in order to obtain benefits from the taxpayer-funded program.
June 17, 2019; Tennessee Department of Finance and Administration
Five Alabama Residents Charged with TennCare Fraud
NASHVILLE, Tenn. - Five residents of Alabama are each charged in separate indictments with TennCare fraud.
June 14, 2019; U.S. Attorney; Northern District of West Virginia
Two Pennsylvania Physicians Acquitted of Drug Charges
WHEELING, WEST VIRGINIA - After an eight-day trial, Dr. Krishan Kumar Aggarwal, of Moon Township, Pennsylvania, and Dr. Cherian John, of Coraopolis, Pennsylvania, were found not guilty of drug charges, United States Attorney Bill Powell announced.
June 13, 2019; U.S. Attorney; Southern District of Georgia
Doctor sentenced to prison for prescribing narcotics to non-patients
SAVANNAH, Ga: A physician with clinics in Pooler, Ga., and Braselton, Ga., was sentenced to nearly three years in federal prison for illegally prescribing drugs to non-patients.
June 5, 2019; New York Attorney General
Upstate New York Pharmacist To Pay $100,000 For Submitting False Claims To Medicare And Medicaid
ALBANY - Attorney General Letitia James and United States Attorney for the Northern District of New York Grant C. Jaquith announced today that Cathy Grossman, the owner and pharmacist-in-charge of Nassau Pharmacy, Inc., will pay $100,000 to resolve allegations that she and Nassau Pharmacy violated the federal and New York False Claims Acts by billing the federal and state governments for prescription drugs that Grossman and her staff never dispensed.
June 4, 2019; Tennessee Department of Finance and Administration
Loudon Co. Woman Charged with TennCare Fraud
NASHVILLE, Tenn. - A Loudon County woman is charged in Knox County with doctor shopping for prescription drugs, using TennCare as payment for the pills. The Office of Inspector General (OIG), with the assistance of the Knox County Sheriff's Office, today announced the arrest of April L. Finger, 45, of Loudon. An investigation led to the identification of five different instances in which Ms. Finger failed to disclose to her medical providers that she had been receiving prescriptions for the painkillers hydrocodone and Tramadol from other providers, using TennCare as payment. A review by the Knox County District Attorney's Office led to criminal charges for three counts of TennCare fraud.
June 3, 2019; Tennessee Department of Finance and Administration
Williamson Co. Woman Charged with TennCare Drug Fraud
NASHVILLE, Tenn. - A Williamson County woman is charged with TennCare fraud in connection with selling prescription drugs she obtained using TennCare healthcare insurance benefits.
June 3, 2019; Tennessee Department of Finance and Administration
Blount Co. Woman Charged with TennCare Fraud
NASHVILLE, Tenn. - A Blount County woman is charged with TennCare fraud for falsely reporting her income and failing to disclose her marriage in order to obtain healthcare insurance benefits through TennCare.

May 2019

May 28, 2019; Massachusetts Attorney General
Sturbridge Home Health Owner Sentenced to Two-and-a-half Years in Jail for Stealing $2.5 Million From MassHealth
Worcester - The owner of a home health agency that previously had offices in Dracut and Worcester was sentenced on Friday to two-and-a-half years in jail in connection with stealing approximately $2.5 million from the state's Medicaid Program (MassHealth), Attorney General Maura Healey announced today.
May 24, 2019; North Carolina Attorney General
Attorney General Josh Stein Announces Medicaid Fraudster Sentenced for $4 Million Scheme
(RALEIGH) Attorney General Josh Stein announced today that Haydn Patrick Thomas of Durham was sentenced to 78 months in prison and three years of supervised release in the Middle District of North Carolina and ordered to pay restitution in the amounts of $3,950,656 to the NC Fund for Medical Assistance and $518,997 to the IRS. Thomas pleaded guilty in September to one count of making a false statement relating to health care matters and one count of tax evasion.
May 15, 2019; Massachusetts Attorney General
Jury Convicts Home Health Agency Owner of Stealing $2.5 Million Dollars from MassHealth
Worcester - After a 10-day jury trial, the owner of a home health agency that previously had offices in Dracut and Worcester has been convicted on charges in connection with stealing approximately $2.5 million from the state's Medicaid Program (MassHealth), Attorney General Maura Healey announced today.
May 13, 2019; Tennessee Department of Finance and Administration
Monroe Co. Woman Charged with TennCare Drug Fraud
NASHVILLE, Tenn. - A Monroe County woman is charged with TennCare fraud for selling the painkiller hydrocodone she allegedly obtained using TennCare healthcare insurance benefits.
May 10, 2019; New York Attorney General
Attorney General James Announces Twelve Convictions In Multi-Million Dollar Medicaid Medical Mill Case
NEW YORK -- Attorney General Letitia James today announced the convictions of Tea Kaganovich, 47, and Ramazi Mitaishvili, 58, both from Brooklyn, and Bernard Bentley, M.D., 61, of East Hampton, for their roles in fraudulently billing Medicaid for more than $8 million for fraudulent diagnostic testing services. Kaganovich and Mitaishvili were both convicted on charges of Grand Larceny in the First Degree; and Bentley, M.D., convicted on charges of Grand Larceny in the First and Third Degrees. Sophisticated Imaging, Inc., and East Coast Diagnostic, Inc., corporations owned by Kaganovich; East West Management, Inc., a corporation owned by Mitaishvili; and Bentley Medical PLLC, a company owned by Bentley, also each pled guilty to Grand Larceny in the First Degree.
May 9, 2019; Connecticut Division of Criminal Justice
New Britain Woman Charged in Scheme to Defraud Medicaid
A New Britain woman was arrested today and charged with fraudulently billing Medicaid for care she claimed to have provided to a Rocky Hill man, including at a time when she was out of the country on vacation.
May 8, 2019; U.S. Attorney; District of Nevada
Nevada Cardiologist Sentenced To Three Years In Prison For Unlawful Distribution Of Opioids
RENO, Nev. - Dr. Devendra I. Patel, aka Devendrakumar I. Patel, a northern Nevada cardiologist was sentenced Tuesday to three years and one month in federal prison for prescribing highly addictive pain pills Oxycodone and Hydrocodone at a high rate to his patients without a medical purpose.
May 8, 2019; Tennessee Department of Finance and Administration
Marshall Co. Man Charged with TennCare Drug Fraud
NASHVILLE, Tenn. - A Marshall County man is charged with TennCare fraud for using the program to obtain prescription drugs, which he's accused of selling.
May 7, 2019; Florida Attorney General
Attorney General's Senior Protection Team Announces First Arrest
TALLAHASSEE, Fla.-Attorney General Ashley Moody today announced the first arrest in connection with the newly-formed Senior Protection Team. Acting on a complaint sent to the Team, investigators began looking into allegations that a Florida senior fell victim to contractor fraud following Hurricane Michael. The victim's home suffered damage during the storm. The victim paid a contractor $5,000 for repairs that the contractor never completed.
May 6, 2019; New Jersey Attorney General
Attorney General James Announces Arrest Of Two Physicians On Charges Of Health Care Fraud At Opioid Mill
NEW YORK-- Attorney General Letitia James today announced the arrest and arraignment of Ilya Smuglin, M.D., 50, of Rego Park, New York and Clarisse Clemons, M.D., 63, of Rockville Centre, New York for allegedly conspiring to operate an opioid mill and fraudulently billing Medicaid. Smuglin and Clemons are charged with Criminal Sale of a Prescription for a Controlled Substance or of a Controlled Substance by a Practitioner or Pharmacist, Health Care Fraud in the First Degree, and Conspiracy in the Fourth Degree.
May 2, 2019; Kentucky Attorney General
Beshear: Medicaid Fraud Unit Secures Guilty Plea of Former Eastern Kentucky Suboxone Clinic Doctor
FANKFORT, Ky. (May 2, 2019) - Attorney General Andy Beshear and his Office of Medicaid Fraud and Abuse today announced a former Eastern Kentucky doctor pleaded guilty to eight counts related to the illegal operation of a Suboxone clinic in Lawrence County.
May 1, 2019; Florida Attorney General
Three Arrested for Exploitation of Elderly and Disabled Adults
TALLAHASSEE, Fla.-Attorney General Ashley Moody today announced the arrests of three individuals for exploiting elderly persons and disabled adults. The arrests follow three separate investigations by the Attorney General's Medicaid Fraud Control Unit. According to the investigations, all three defendants separately stole thousands of dollars from the bank accounts and trust funds of eight elderly and disabled Floridians.
May 1, 2019; Tennessee Department of Finance and Administration
Hardin Co. Woman Must Repay State
NASHVILLE, Tenn. - A Hardin County woman is ordered to repay the state more than $15,000 after she was charged with TennCare fraud for allegedly lying about her residency to enroll in the state's healthcare insurance program.

April 2019

April 30, 2019; Tennessee Department of Finance and Administration
Davidson Co. Man Charged with TennCare Fraud
NASHVILLE, Tenn. -- A Davidson County man is charged with TennCare fraud for posing as the spouse of a TennCare enrollee in order to pick up her prescription for the painkiller Oxycodone.
April 29, 2019; Tennessee Department of Finance and Administration
Gibson Co. Residents Charged with TennCare Fraud
NASHVILLE, Tenn. -- Two residents of Gibson County are each charged in nearby Madison County with using the identity and TennCare benefits of each other's minor children.
April 25, 2019; Arkansas Attorney General
Rutledge Announces Arrest of New Beginnings Health Services Owner for Medicaid Fraud and Tax Evasion
LITTLE ROCK - Arkansas Attorney General Leslie Rutledge announced today the arrest of the owner and CEO of New Beginnings Behavioral Health Services LLC, Chirie Bazzelle.
April 24, 2019; Missouri Attorney General
AG Schmitt Secures $310,000 in Restitution for Financial Exploitation of Disabled Citizen and Medicaid Recipient
Jefferson City, Mo. - Missouri Attorney General Eric Schmitt announced today that Mary McDonald of Bismark, Missouri, was ordered by the St. Francois County Circuit Court to pay $310,000 in restitution for financially exploiting a disabled resident who was under McDonald's care. This is one of the largest restitution amounts secured by Attorney General Schmitt since he took office.
April 10, 2019; Connecticut Attorney General
State Announces Joint Federal-State False Claims Act Settlement with Waterbury Social Worker
(Hartford, CT) -Connecticut Attorney General William Tong and state Department of Social Services (DSS) Commissioner Roderick L. Bremby today announced a joint federal-state settlement with a school social worker who will pay $145,855 and will be suspended from participating in Connecticut's Medicaid program for three years to settle allegations that she submitted false claims for payment for psychotherapy services for children who were Medicaid recipients.
April 11, 2019; North Carolina Attorney General
Attorney General Josh Stein Announces Two Medicaid Fraudsters Sentenced
(RALEIGH) Attorney General Josh Stein today announced Lisa Carol Raymond of Greenville, North Carolina, and Robert Paul Maglicic Jr. of Miami, Florida, were sentenced in the Eastern District Court of North Carolina after pleading guilty to conspiracy to commit health care fraud in December. Raymond was sentenced to seven months in prison, three years of supervised release, and ordered to pay $2,069,082.15 in restitution and $100 in special assessment. Maglicic was sentenced to 42 months in prison, three years of supervised release, and ordered to pay $2,069,082.15 in restitution and $100 in special assessment.
April 10, 2019; Tennessee Department of Finance and Administration
Rhea County Woman Charged with TennCare Fraud
NASHVILLE, Tenn. -- A Rhea County woman is charged with TennCare fraud for falsely reporting her income and household composition in order to obtain TennCare benefits.
April 4, 2019; Tennessee Department of Finance and Administration
Davidson Co. Woman Must Repay TennCare in Fraud Plea Deal
NASHVILLE, Tenn. -- A Davidson County woman is ordered to repay the state after she entered a plea agreement on charges involving TennCare fraud.
April 2, 2019; Tennessee Department of Finance and Administration
Hardin Co. Woman Charged with TennCare Fraud
NASHVILLE, Tenn. -- A Hardin County woman is charged with allegedly lying about her residency in order to enroll in TennCare.

March 2019

March 29, 2019; U.S. Attorney; Central District of Illinois
Owner of Former Springfield Medical Supply Business Sentenced to Two Years in Prison for Medicaid Fraud
SPRINGFIELD, Ill. - A former Springfield, Ill., man whose business supplied incontinence products to Medicaid recipients, Kevin W. Schaul, was sentenced today for defrauding Illinois' Medicaid program. U.S. District Judge Sue E. Myerscough ordered that Schaul, 53, currently of Augusta, Mo., serve 24 months in federal prison and pay restitution in the amount of $582,844. Schaul's prison term will be followed by a three-year term of supervised release, with the first six months as home confinement. Schaul was ordered to report to serve his prison term on a date to be determined by the federal Bureau of Prisons.
March 25, 2019; Tennessee Department of Finance and Administration
Tipton County Woman Charged with TennCare Drug Fraud
NASHVILLE, Tenn. -- A Tipton County woman is charged with TennCare fraud in connection with the sale of prescription drugs paid for by the state's health care insurance program.
March 20, 2019; Louisiana Attorney General
Across Louisiana, Arrests Made for Medicaid Welfare Fraud
BATON ROUGE, LA - Five Louisiana Medicaid recipients have been arrested on charges related to welfare fraud, announced Louisiana Attorney General Jeff Landry. The arrests come after investigations by the Louisiana Bureau of Investigation, the Louisiana Department of Health, and the Louisiana Legislative Auditor's Office.
March 18, 2019; Nevada Attorney General
Attorney General Ford Announces Sentencing of Medicaid Provider
Las Vegas, NV - Nevada Attorney General Aaron D. Ford announced that Felecia Bluntson, 34, of Las Vegas, was sentenced today in a Medicaid fraud case involving false billing for medical services to Medicaid recipients. The fraud occurred between May 2016 and September 2016.
March 15, 2019; New York Attorney General
Attorney General James Announces Sentencing Of Owner Of Three Manhattan Pharmacies For Defrauding Medicaid
NEW YORK - Attorney General Letitia James today announced the sentencing of licensed pharmacist Hin T. Wong ("Wong"), 50, of Manhattan, the owner of three Manhattan pharmacies in connection with a multi-million dollar Medicaid fraud scheme involving HIV drugs. Wong was sentenced today before Manhattan Supreme Court Justice Mark Dwyer to a term of incarceration of two to six years in state prison. Wong additionally forfeited over $3,600,000 as restitution to the New York State Medicaid program.
March 4, 2019; Massachusetts Attorney General
Brockton Adult Foster Care Provider Resolves Allegations of MassHealth Fraud
Boston - Victory Human Services Inc. (Victory) will pay more than $548,000 to resolve allegations that it fraudulently charged the state's Medicaid program (MassHealth) for Adult Foster Care (AFC) services, Attorney General Maura Healey announced today.
March 1, 2019; Tennessee Department of Finance and Administration
Hamilton Co. Woman Charged with ID Theft, TennCare Fraud
NASHVILLE, Tenn. -- A Hamilton County woman is charged with TennCare fraud in connection with using another person's identity in order to obtain controlled substances.

February 2019

February 21, 2019; Massachusetts Attorney General
Newton Doctor to Pay $680,000 to Resolve Allegations That He Overbilled MassHealth for Services at Nursing Homes
Boston - A Newton physician will pay $680,000 in restitution and penalties and has agreed to be subject to a comprehensive compliance program to resolve allegations that his office routinely overbilled the state's Medicaid program (MassHealth) for services at nursing homes, Attorney General Maura Healey announced today.
February 21, 2019; Kentucky Attorney General
Beshear Secures more than $5 Million for Kentucky from Medicaid Fraud Settlement with Nation's Largest Kidney Dialysis Provider
FRANKFORT, KY. (Feb. 21, 2019) - Attorney General Andy Beshear is returning more than $5 million to the Kentucky Medicaid program from a settlement with Fresenius Medical Care Holdings Inc. over allegations of Medicaid fraud.
February 19, 2019; Texas Attorney General
AG Paxton Recovers Record $236 Million for Texas in Medicaid Fraud Settlement
Attorney General Ken Paxton today announced that Xerox Corporation and several of its former subsidiaries - including Conduent, Inc. - agreed to a $235.9 million settlement with the State of Texas to resolve a lawsuit brought under the Texas Medicaid Fraud Prevention Act (TMFPA) and other grounds regarding the processing of prior authorization requests by dentists to deliver orthodontic services to Medicaid patients.
February 15, 2019; North Carolina Attorney General
Attorney General Josh Stein Announces Medicaid Fraudster Sentencing
(RALEIGH) Attorney General Josh Stein today announced that Tamara McCaffity of Durham was sentenced to 46 months in prison and three years of supervised release following a conviction for Conspiracy to Commit Health Care Fraud in the United States District Court for the Eastern District of North Carolina. She was also ordered to pay restitution in the amount of $523,783 and forfeit three houses. Two other individuals, Christopher Brown and Darryl Sanford, have already pleaded guilty and were sentenced as part of this conspiracy.
February 13, 2019; Nevada Attorney General
Attorney General Ford Announces Sentencing of Fraudulent Medicaid Provider Business
Las Vegas, NV - Nevada Attorney General Aaron D. Ford announced that Moving Forward Counseling Solutions, LLC (Moving Forward), a Medicaid provider business based out of Las Vegas, was sentenced for Medicaid fraud. The fraud was committed between January 2016 and December 2016.
February 11, 2019; Nevada Attorney General
Attorney General Ford Announces Sentencing of Former Medicaid Provider Business Owner Doretha Scott
Las Vegas, NV - Nevada Attorney General Aaron D. Ford announced that Doretha Scott, 65, of Las Vegas, was sentenced today in a Medicaid fraud case involving submitting false claims to Nevada Medicaid. The fraud occurred between December 2015 and January 2017.
February 7, 2019; U.S. Attorney; Western District of Virginia
Lebanon Doctor Sentenced on Federal Drug Distribution Charges
Abingdon, VIRGINIA - A medical doctor who previously practiced in Lebanon, Va. was sentenced today to serve 151 months in federal prison following convictions on federal drug and healthcare fraud charges. First Assistant United States Attorney Daniel P. Bubar and the Office of the Virginia Attorney General made the announcement.
February 5, 2019; U.S. Attorney; Middle District of Tennessee
Skilled Nursing Facility Management Company Agrees to Settle False Claims Act Allegations
NASHVILLE, Tenn. - February 5, 2019 - Tennessee Health Management, Inc. ("THM") has agreed to pay $9,764,107.98 to settle allegations that it violated the False Claims Act, announced U.S. Attorney Don Cochran for the Middle District of Tennessee. The alleged conduct involved the submission of false claims for payment to TennCare, Tennessee's Medicaid Program, related to nursing facility services to TennCare beneficiaries.
February 4, 2019; Tennessee Department of Finance and Administration
Weakley Co. Woman Charged with TennCare Drug Fraud
NASHVILLE, Tenn. - A Weakley County woman is charged in nearby Madison County with TennCare fraud involving doctor shopping, which involves fraudulent use of the state's healthcare insurance program to obtain controlled substances.
February 4, 2019; New York Attorney General
Disbarred Plastic Surgeon Brad Jacobs Pleads Guilty to Felony Charges in Two Counties; Will Be Sentenced to 3 to 9 Years in Prison
NEW YORK - Attorney General Letitia James today announced the conviction of disbarred plastic surgeon Brad Jacobs, 56, of Westbury, NY, in New York and Nassau Counties for engaging in a 4-year scheme to illegally perform surgeries on patients, and for committing a massive disability insurance and welfare fraud scheme. Today, the defendant pleaded guilty in New York County to one count of Grand Larceny in the Third Degree, two counts of Unauthorized Practice of a Profession, and one count of Scheme to Defraud in the First Degree. Last week, the defendant pleaded guilty in Nassau County to one count of Insurance Fraud in the Second Degree and one count of Welfare Fraud in the Third Degree.
February 4, 2019; U.S. Attorney; Southern District of West Virginia
Doctor Enters into Civil Settlement to Pay Restitution and Damages to the WV Medicaid Program
CHARLESTON, W.Va. - United States Attorney Mike Stuart announced that Dr. Manuel C. Barit, M.D., 71, of Raleigh County, and the only practicing physician at the Mullens Family Clinic, has entered into a civil settlement with his office to pay over $200,000, including full restitution and damages to the WV Medicaid Program. Earlier this week, Barit also entered a guilty plea to a healthcare fraud scheme.
February 1, 2019; Kentucky Attorney General
Beshear: Two Former Hazard Caregivers Plead Guilty to Abusing, Neglecting Adult
HAZARD, Ky. (Feb. 1, 2019) - Attorney General Andy Beshear and his Office of Medicaid Fraud and Abuse today announced the guilty pleas of two former caregivers on abuse charges of a vulnerable Kentuckian at a Hazard mental and physical disability facility in 2016.
February 1, 2019; Louisiana Attorney General
Government Worker Charged in Elaborate Welfare Benefits Scheme
BATON ROUGE, LA - Attorney General Jeff Landry today announced an arrest of a government employee by his Medicaid Fraud Control Unit.

January 2019

January 8, 2018; New York Attorney General
Attorney General James Announces Conviction Of "Three-Quarter House" Director Charged With Defrauding Medicaid Through A Kickback Scheme
NEW YORK, NY -Attorney General Letitia James announced the conviction of Robert H. Corrado, 57 and Interline Employee Assistance Program, Inc. (Interline) for engaging in a systematic kickback scheme and violating patients' rights. In 2017, the Attorney General's Medicaid Fraud Control Unit ("MFCU") secured an indictment and filed several civil causes of action against Robert Corrado, Kristina Corrado, and Interline seeking to recover monies improperly obtained as a result of their criminal conduct. Since 2015, MFCU's "three-quarter house" investigations have brought down three groups of fraudulent housing and treatment providers, including Narco Freedom, the Baumblit Group, and Interline.