Case Manager Arrested After Billing Medicaid for Deceased Recipient

April 24, 2007 -- TALLAHASSEE, FL – Florida Attorney General Bill McCollum today announced the arrest of a South Florida mental health case manager on charges that he defrauded the Florida Medicaid program out of more than $2,000. Hector Payares allegedly billed the Medicaid program for treatment provided to a Medicaid recipient even though the woman had been deceased for nearly two months.

The Attorney General’s Medicaid Fraud Control Unit began investigating Payares after receiving information from the Agency for Health Care Administration. Investigators believe Payares prepared and submitted service activity logs to his employer, New Horizons Community Mental Health Center, documenting his alleged treatment of a Medicaid recipient who passed away in late 2004. Payares also documented statements allegedly made by the victim well after the date of her death.

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New Horizons Community Mental Health Center, upon discovering the fraud, immediately returned the fraudulently billed sum to the Medicaid program.

Payares is currently being held in the Miami-Dade County Jail. He is charged with grand theft and organized scheme to defraud, both third-degree felonies. Payares faces a maximum prison sentence of five years in prison and a $5,000 fine for each of those charges. The case will be prosecuted by the Miami-Dade County State Attorney’s Office.

Source: Florida Attorney General