By George F. Indest III, J.D., M.P.A., LL.M., Board Certified by The Florida Bar in Health Law
An Apopka businesswoman was recently sentenced to 18 months in prison after she was found guilty of a Medicaid scam. According to the Florida Attorney General’s Office, Shanqual Marshall-Gunn was arrested in September on suspicion of submitting more than $47,000 in fraudulent Medicaid claims.
Company Provided Targeted Case Management Services (TCMs).
Marshall-Gunn owned Second Chances TCM, Inc. TCMs are intended to provide Medicaid recipients who have mental-health disorders with connections to resources in their community, and to assist them in leading a more normal life. Prosecutors said Marshall-Gunn gave employees and clients kickbacks when they submitted referrals to her company.
Three of her employees were also arrested in September 2014 for billing Medicaid for targeted case management services that were fraudulent or not authorized.
Marshall-Gunn Entered a No Contest Plea.
Media reported that court records show Marshall-Gunn entered a no contest (or “nolo contendere”) plea and was found guilty of Medicare fraud, a second-degree felony. Circuit Court Judge Jenifer Davis sentenced Marshall-Gunn on July 2. Davis also ordered Marshall-Gunn to serve five years of probation.
In addition, she cannot work for any Medicaid provider and must pay more than $47,000 in restitution.
The Investigation Was Conducted by the Medicaid Fraud Control Unit.
The investigation was conducted by Attorney General Pam Bondi’s Medicaid Fraud Control Unit (MFCU). And it was prosecuted by the Attorney General’s Office of Statewide Prosecution.
Bondi’s MFCU investigates and prosecutes providers that intentionally defraud Florida’s Medicaid program. According to Bondi’s MFCU press release in this case: “From January 2011 to August 2014, Attorney General Bondi’s MFCU has obtained more than $460 million in settlements and judgments.”
To read the press release, click here.
To read more about the MFCU, click here.
Comments?
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Contact Health Law Attorneys Experienced in Handling Medicaid Audits, Investigations and other Legal Proceedings.
Medicaid fraud is a serious crime and is vigorously investigated by the state MFCU, the Agency for Health Care Administration (AHCA), the Zone Program Integrity Contractors (ZPICs), the FBI, the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (DHHS). Often other state and federal agencies, including the U.S. Postal Service (USPS), and other law enforcement agencies participate. Don’t wait until it’s too late. If you are concerned of any possible violations and would like a confidential consultation, contact a qualified health attorney familiar with medical billing and audits today. Often Medicaid fraud criminal charges arise out of routine Medicaid audits, probe audits, or patient complaints.
The Health Law Firm’s attorneys routinely represent physicians, dentists, orthodontists, medical groups, clinics, pharmacies, assisted living facilities (ALFs), home health care agencies, nursing homes, group homes and other healthcare providers in Medicaid and Medicare investigations, audits and recovery actions.
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Sources:
Attorney General’s Press Office. “Four Central Florida Residents Arrested for Medicaid Fraud.” (Sept. 5, 2014). WCTV. From: http://www.wctv.tv/home/headlines/Four-Central-Florida-Residents-Arrested-for-Medicaid-Fraud-274154191.html
Connolly, Kevin P. “Apopka woman sentenced to prison for 18 months after Medicaid scam.” Orlando Sentinel. Print.
About the Author: George F. Indest III, J.D., M.P.A., LL.M., is Board Certified by The Florida Bar in Health Law. He is the President and Managing Partner of The Health Law Firm, which has a national practice. Its main office is in the Orlando, Florida area. www.TheHealthLawFirm.com The Health Law Firm, 1101 Douglas Ave., Altamonte Springs, FL 32714, Phone: (407) 331-6620.
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