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Medicaid Fraud Leads To More Indictments

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Health Care Fraud
carol-daniel Carol Daniel
Carol A. Daniel is first and foremost a mother and wife. She and her...
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ST. LOUIS (KMOX) – Two dozen indictments unsealed in a second wave of indictments for Medicaid abuse.

U.S. Attorney Stephen Wiggington for the southern district of Illinois, says 15 individuals were hit with 12 indictments for abuse of the personal care program, which was designed to allow personal care for Medicaid recipients instead of more expensive nursing home care.

“This included both personal assistants, who were not doing the work that they claimed to be doing, and beneficiaries, who were having ghost personal assistants and were collecting the money themselves,” Wiggington says.

He says the biggest problem was how poorly the program was being monitored.

“We looked at the overall structure of the program and it is terribly flawed and we’re making recommendations of how it should change and why it should change,” he says.

One example of the poor monitoring, Wiggington says, was when a man was in jail for several months, while Medicaid was still paying him as a personal care assistant.

He also says one individual took $5,000 and another received more than $200,000 illegally.

Most were individual cases of fraud, Wiggington says, but two indictments alleged the beneficiary and assistant split the money. The charges of “Health Care Program Fraud” carry a maximum penalty of 10-years in prison, a $250,000 fine, and up to three years of supervised release.

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