Metro East Personal Assistant Facing Health Care Fraud Charges

EAST SAINT LOUIS, Ill. – Shomanicka Holly, 36, of East Saint Louis, Illinois, was arraigned in federal court today after a grand jury returned an indictment charging her with three counts of felony health care fraud.

The indictment alleges that Holly served as a personal assistant from 2016 to 2019 for a qualified beneficiary enrolled in the Illinois Department of Human Services Home Services Program. The Home Services Program is a Medicaid program in Illinois that provides personal assistants to
Medicaid recipients to assist them with general household activities and personal care. It is designed to reduce Medicaid expenditures by avoiding more expensive institutional care, including nursing home care.

According to the indictment, Holly submitted false timesheets requesting payment for personal assistant services that she never actually performed because she was working at another job, not caring for the Medicaid recipient. In doing so, Holly allegedly defrauded the program and breached its policies stating that personal assistants “cannot charge [the Home Services Program] for the same hours worked when working another job” and “billing for hours not worked constitutes Medicaid fraud.”

Holly’s case is set for trial on October 4, 2021, at 9:00am, before United States District Judge David W. Dugan in the federal courthouse in East St. Louis. If convicted, Holly faces a maximum penalty of 10 years in prison on each fraud count.

An indictment is a formal charge against a defendant. Under the law, a defendant is presumed to be innocent of a charge until proved guilty beyond a reasonable doubt to the satisfaction of a jury.

This case was investigated by agents of the U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG) and the Illinois State Police, Medicaid Fraud Control Bureau (MFCB). The case is being prosecuted by Assistant United States Attorney Luke J. Weissler.

Source: Metro East Personal Assistant Facing Health Care Fraud Charges / U.S. Department of Justice District of Illinois

Leave a Reply

Your email address will not be published.