Indiana AG Reports a Record $14 Million Recovered by the Medicaid Fraud Control Unit in 2007

Unit investigated more than 1450 abuse, neglect and fraudulent billing cases

March 27, 2008 -- (INDIANAPOLIS, IN) – Indiana Attorney General Steve Carter’s Medicaid Fraud Control Unit (MFCU) investigators recovered a record $14 million for the Medicaid Program in 2007 announced Carter today. The Unit also completed 219 fraudulent billing cases and 1235 abuse and neglect cases in 2007.

“Those that cheat the Medicaid system hurt the patients they serve and increase healthcare costs over the long run,” Carter said. “This latest success builds upon the successes by the Unit over the last several years. Since 2004 the unit has recovered $34 million for the State. We will continue to work with federal, state and local law enforcement to pursue justice against those that would commit fraud against patients and the public healthcare program.”

Between January 1, 2007 and December 31, 2007, MFCU investigations have lead to 17 criminal prosecutions for billing fraud or patient abuse and neglect. Eleven (11) of those cases have resulted in criminal convictions with four cases pending. Additionally, another seven (7) individuals were convicted in 2007 as a result of charges filed in 2006.

The MFCU works with federal, state and local law enforcement agencies during its investigations and prosecutions of wrongdoers to recover funds improperly taken from the Medicaid program and to seek justice against those who would harm patients. Medicaid is a joint federal-state program that provides health insurance for the poor.

Some of the 2007 convictions and cases where the MFCU participated in investigations and prosecutions include:

* Varnador Sutton and Antoinette Alexander – Indianapolis, IN, arrested and charged for fraudulently billing and receiving more than $3.3 million for psychotherapy and counseling services that were never provided. Approximately $2 million in assets seized.

* William Higdon – Jasper, IN, charged with Medicaid billing fraud. He co-operated a taxi-cab company that transported patients to doctor appointments.

* Bristol-Myers Squibb – paid Indiana $5.8 Million as part of a multi-state settlement over illegal marketing and pricing practices including the antipsychotic drug Abilify, and the anti-depressant Serzone.

* Jennifer Williams – Indianapolis, IN, arrested and charged for fraudulently billing the Medicaid program. She transported ambulatory patients and billed Medicaid as if the patients had been confined to wheelchairs.

* Kathy Stinson – Jeffersonville, IN – Licensed Practical Nurse arrested and charged for Interference with Medical Services and Exploitation of an Endangered Adult. Stinson is from Louisville, Kentucky and worked in Indiana. She is alleged to have coerced one of her patients to save her prescribed medications for her own personal use.

* Gani Azeez – Gary, Indiana, pled guilty for defrauding the program of as much as $17,000.

“Each case requires strong investigative work and collaboration with local and federal authorities,” Carter added. “We continue to find ways to collaborate and to share information in order to most efficiently prosecute cases against those who would commit healthcare fraud whether it is a billing issue or a physical matter against the elderly and disabled.”

The Indiana Attorney General’s Medicaid Fraud Control Unit criminal investigations are referred to federal and state prosecutors for charging. MFCU investigators and attorneys often assist in the prosecution efforts as well.

For more information on the MFCU go online to www.attorneygeneral.IN.gov and follow the links under Consumer Services.

Source: Indiana Attorney General