DOJ Announces Medicaid Fraud Guilty Plea

On Friday, the Department of Justice announced a guilty plea from a licensed attorney in a case regarding falsified timesheets and medical claims made to Medicaid by the defendant while she was working as a home health aid from 2016 to 2018. These false claims resulted in unwarranted payments of $131,656 from D.C. Medicaid for services that were not actually rendered to Medicaid patients.

The defendant worked for two different home health agencies in the Washington, D.C. area during this time period. However, also during this time period the defendant was attending law school in Baltimore. The defendant has pled guilty to false timesheets that claim that the defendant provided hundreds of hours of home health services through the two different home health agencies, when in fact the defendant was en route to, en route from, or actually attending classes in Baltimore.

118 separate instances were noted specifically in the plea, One specific instance noted the plaintiff submitted one time sheet for services from 7AM to 3PM and then another spreadsheet from 3:30PM until 8:30 PM for two patients in D.C., when in fact the plaintiff’s cell phone records and key card swipes from her student access card show her physically present in Baltimore the entire day.

The defendant has pled guilty to health care fraud and faces possible imprisonment of up to 10 years. The plaintiff has also agreed to pay restitution in the amount of $131,656.12. Judge Carl J. Nichols scheduled sentencing for Feb. 22, 2022.

Source: DOJ Announces Medicaid Fraud Guilty Plea / Law Street

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