By George F. Indest III J.D., LL.M., Board Certified by The Florida Bar in Health Law
The director of a center for developmentally challenged adults in Okaloosa County, Florida, was arrested on August 16, 2012, for allegedly fraudulently billing Medicaid for more than $270,000 for services under the Medicaid Developmentally Disabled Waiver Program, according to the Attorney General’s (AG) office.
To read the entire press release from the AG’s office, click here.
Director Allegedly Submitted False Claims for Non-Billable Services and Falsified Hours.
According to the press release, in 2009, the Medicaid Fraud Control Unit (MFCU) began investigating the center after it received a referral from the Agency for Persons with Disabilities (APD). The director allegedly submitted claims seeking $270,000 in reimbursements for non-billable services and falsified hours to the Medicaid program.
Director Faces Serious Medicaid Fraud Charges.
The director of the center has been charged with one count of first-degree Medicaid fraud and two counts of third-degree Medicaid fraud. If convicted, the director could receive 40 years in prison and $25,000 in fines, this is all according to the AG’s Office.
To learn more on our experience with Medicaid investigations, click here.
MFCU and State and Federal Auditing Agencies.
The MFCU receives referrals from many other state and federal agencies. Often, matters that could be resolved as simple billing errors get escalated to criminal charges when Medicaid providers are interviewed and give evidence against themselves. Admitting to any misconduct, no matter how slight, may lead to far more serious criminal charges.
Click here for tips on how to respond to a Medicaid audit.
Contact Health Law Attorneys Experienced in Handling Medicaid Audits.
Medicaid fraud is a serious crime and is vigorously investigated by the state MFCU, the Agency for Healthcare 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, medical groups, clinics, pharmacies, assisted living facilities (AFLs), home health care agencies, nursing homes, group homes and other healthcare providers in Medicaid and Medicare investigations, audits and recovery actions.
To contact The Health Law Firm please call (407) 331-6620 or (850) 439-1001 and visit our website at www.TheHealthLawFirm.com.
Sources:
McFarland, Molly. “Attorney General’s Office Arrests Okaloosa County Resident for $270,000 in Medicaid Fraud.” Florida Office of the Attorney General. (August 16, 2012). From: http://www.myfloridalegal.com/newsrel.nsf/newsreleases/B2185C605D2C5BF985257A5C0065645A
Ricketts, Dusty. “Local Nonprofit Director Charged with Medicaid Fraud.”NWFdailynews.com. (August 16, 2012). From: http://www.nwfdailynews.com/articles/fraud-51752-medicaid-.html
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.
“The Health Law Firm” is a registered fictitious business name of George F. Indest III, P.A. – The Health Law Firm, a Florida professional service corporation, since 1999.
Copyright © 1996-2012 The Health Law Firm. All rights reserved.
