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Child
Support Enforcement
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| January 2004 |
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In Washington, a man pled guilty and was sentenced to 5 years probation and ordered to pay $135,000
in restitution for failure to pay child support. Since their 1991 divorce, the custodial parent has
raised their five children on her own. The man worked in Texas and Colorado using an alias.
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Durable
Medical Equipment
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| January 2004 |
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An owner of a DME supply company was sentenced to 2 years imprisonment and ordered to pay $273,000
in restitution and pay a $2,500 fine for mail fraud in connection with a Medicaid fraud scheme. The
man submitted claims to Wisconsin’s medical assistance program for DME that was never provided.
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In Tennessee, the sales manager for a DME supplier was ordered to pay $24,000 in restitution for
his role in a scheme to defraud Medicare. A joint investigation with the Federal Bureau of Investigation
and the Medicaid Fraud Control Unit revealed that the manager routinely completed the clinical sections
of certificates of medical necessity, falsely stating patients had qualifying conditions for alternating
pressure mattresses.
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Home
Health Agency
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| January 2004 |
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In Minnesota, the last subject in a complex home health care investigation was sentenced. The
woman, a director of nursing, pled guilty and was ordered to pay $53,000 in restitution for health
care fraud. Through the woman’s involvement in the scheme, home health services were billed
that were provided to beneficiaries who were not homebound and/or that were not medically necessary.
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Medicaid
Fraud
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January 2004
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In Washington, a man was sentenced to 30 days in jail and ordered to pay $4,000 in restitution
for defrauding the Medicaid program. As the State appointed guardian for his father, he continued
to submit claims to Medicaid after his death.
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