MM Curator summary

[MM Curator Summary]: The case centers arounds decisions around evacuating residents during Huricane Ida.

 
 

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

Dean arrested in Tangipahoa Parish after evacuating 800+ nursing home residents to warehouse

 
 

 
 

The Louisiana Attorney General’s Office has arrested notorious nursing home magnate Bob Dean on counts of cruelty to persons with infirmities and other charges, nearly a year after Dean bungled the evacuation of hundreds of seniors ahead of Hurricane Ida last August.

 
 

Prosecutors arrested Dean after he turned himself in Wednesday on eight felony counts of cruelty to persons with infirmities, five felony counts of Medicaid fraud and two felony counts of obstruction of justice. Dean was booked in the Tangipahoa Parish Prison after a judge set a $350,000 bail, according to court filings and his lawyer. 

The Wednesday arrest was the cap on a 10-month long criminal investigation into Dean’s actions during Ida last year. Before the storm struck, Dean moved more than 800 elderly and frail residents from his seven nursing homes to a Tangipahoa Parish warehouse, which state inspectors shut down after observing residents calling for help that never came as trash piled up and air conditioning went out. Dean kicked inspectors off-site after the storm. 

More than a dozen residents died after that evacuation, though coroners have classified only five as “storm-related.“ Shortly after, the AG’s office opened its probe, and families of nursing home residents filed a slew of lawsuits against Dean.

The state also shuttered Dean’s nursing homes, while federal officials revoked his ability to receive money through Medicaid. Dean has filed appeals on both of those actions.

Dean “refused to move his residents out of the warehouse following Hurricane Ida, billed Medicaid for dates his residents were not receiving proper care and engaged in conduct intended to intimidate or obstruct public health officials and law enforcement,” the AG’s office said in a statement.

Dean’s bond requires mental health evaluation, ankle monitor

Dean’s attorney, John McLindon, said Wednesday that the Attorney General’s office contacted him earlier this week about the arrest and that Dean and his wife flew back to Louisiana on Tuesday. Dean moved to Georgia last year. 

McLindon said that Dean’s actions during the evacuation were not criminal. He said Dean was out of the state when Hurricane Ida hit, and that flights heading back to Louisiana were canceled. 

“When you hear the charge cruelty to the infirm — understand, Bob Dean was not there,” McLindon said. “He was out of state desperately trying to get back.”

McLindon asked Tangipahoa District Judge Jeff Johnson for permission for Dean to leave Louisiana and travel back to Georgia once he meets bail obligations, and that Johnson agreed. Dean was expected to bond out Wednesday afternoon. 

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Tangipahoa Parish Sheriff’s Office Chief Jimmy Travis said Dean’s $350,000 bond includes conditions that he must wear an ankle monitor, surrender his passports and firearms and receive a mental health evaluation. Travis said Dean was also ordered not to leave Georgia except for medical appointments and to return to Louisiana for court. All of Dean’s court appearances must also be in-person, unless he’s confined to a medical facility.

McLindon said Dean is facing significant health problems; in other lawsuits Dean is facing, his attorneys have said he has dementia and other memory problems. Those health problems could “absolutely” become part of Dean’s criminal defense, McLindon said.

Dean is also facing criminal counts in other states. After an incident earlier this year where Dean shot his thumb off, police in Georgia charged him with reckless conduct, firing a weapon near a public road and firing a weapon on another person’s property. Dean is also under a criminal investigation in Oregon after cattle from his ranch had to be rescued from a snowstorm.

‘Cruelty to infirm’ carries stiff penalties 

In Louisiana, “cruelty to the infirmed” counts can be even more serious than negligent homicide. If Dean were convicted on any of those eight counts, he could face up to 10 years in prison for each, five years longer than the maximum penalty for negligent homicide. 

It’s rare for nursing home owners to face criminal charges, said attorney Jim Cobb, who represented the owners of St. Rita’s Nursing Home in St. Bernard Parish after 35 of their residents drowned in Hurricane Katrina’s floodwaters. A jury acquitted them in 2007 on dozens of counts of negligent homicide and cruelty to the infirm.

Cobb said that despite his victory in the St. Rita’s case, jurors are often predisposed to side with the elderly in cruelty cases. And he said the videos and photos of Dean’s residents crying out for help during the Hurricane Ida evacuation are powerful evidence against him.

Dean could try to make the case that some of his nursing homes were under mandatory evacuation orders and that staff did the best they could, Cobb said. Dean owned Maison DeVille and South Lafourche Nursing and Rehab in parishes that issued such mandatory orders for the storm. 

Meanwhile, prosecutors will need to try to prove that Dean’s mistreatment of his nursing home residents was intentional, he said.

Dean’s mental state could also have major bearing over the outcome of the case, Cobb said. He said the courts will try to determine whether Dean has diminished mental capacity and whether he’s capable of helping his lawyers to defend himself.

“He may pull a Junior on ‘The Sopranos’ and pretend he’s demented while avoiding criminal prosecution,” Cobb said.

 
 

Clipped from: https://www.theadvocate.com/baton_rouge/news/article_fc0bcd7a-f256-11ec-94d2-dbb30a30f961.html

MM Curator summary

[MM Curator Summary]: She kept on billing using her man’s provider number even after they split. Throw in a train and a huntin’ dog and you got yourself a country song.

 
 

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

 
 

Kay Le Farmer (Texas Department of Public Safety, Texas Department of Public Safety)

HOUSTON – A 47-year-old Katy resident has been indicted for defrauding Medicaid of more than $600,000, a federal official said Wednesday.

U.S. Attorney Jennifer B. Lowery said authorities took Kay Le Farmer into custody and she is expected to make her initial appearance before U.S. Magistrate Dena Hanovice Palermo at 1 p.m.

On June 9, a federal grand jury returned the 22-count indictment which was unsealed upon her arrest on Wednesday.

According to the charges, Farmer is the former office manager for her ex-husband – a therapist and Medicaid provider. Following their separation, Farmer allegedly used her ex-husband’s provider number to submit fraudulent claims to Medicaid for counseling services that were never provided.

From 2013 until 2018, authorities say Farmer allegedly submitted or caused the submission of approximately $617,983.86 in claims for psychotherapy services that were not provided. The indictment alleges Farmer was paid approximately $432,924.69 on those claims.

In 2017, Farmer even used her employment at a pediatrician’s office to obtain patient information, according to the allegations. She then allegedly submitted more fraudulent claims to Medicaid under her ex-husband’s provider number.

According to the charges, Medicaid monies were deposited into accounts Farmer controlled.

If convicted, Farmer faces up to 10 years in federal prison and a possible $250,000 maximum fine for each count of health care fraud.

The Texas Attorney General’s Medicaid Fraud Control Unit and the Department of Health and Human Services – Office of Inspector General conducted the investigation. Special Assistant U.S. Attorney Kathryn Olson is prosecuting the case.

 
 

Clipped from: https://www.click2houston.com/news/local/2022/06/15/katy-woman-accused-of-defrauding-medicaid-out-of-more-than-600k-using-her-ex-husbands-therapist-information/

MM Curator summary

[MM Curator Summary]: She billed for psychotherapy visits when she basically was just babysitting at bowling alleys and theme parks.

 
 

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

 
 

Jessica Hayes-Cook

A licensed clinical professional counselor in Helena received a six-month deferred sentence after pleading guilty to felony Medicaid fraud for billing Medicaid for services that were not eligible for reimbursement. 

Jessica Hayes-Cook was charged on May 23, following an investigation by the Montana Department of Justice’s Medicaid Fraud Control Unit. She pleaded guilty on June 1.

Court documents note that Hayes-Cook was represented by John E. Smith of Smith & Stephens PC Law Offices in Helena. Smith could not be reached Tuesday afternoon, but another attorney at the firm said they had no comment on the case at this time.

According to an affidavit signed by Assistant Attorney General Daniel Baris, Hayes-Cook was selected to oversee supervised visits between two children and their father as the man and his wife were going through a divorce. The defendant was also selected to provide therapy to one of the children.

The supervised visits first occurred at Hayes-Cook’s office in Helena and were later held at other locations, such as Sleeping Giant Lanes bowling alley and Flying Giant Adventure Park, the affidavit says.

During an interview, the father told an agent Hayes-Cook’s role at the visits was to be present and observe while he played with his children. He said the defendant occasionally asked the children how they were doing or answered their questions when they approached her, but she did not interview the children or discuss their mental health with him.

Hayes-Cook received more than $1,500 in Medicaid payments after billing the majority of the visits to Medicaid as individual psychotherapy for the two children, the affidavit says. Observing parental visitation is not individual psychotherapy and is not billable to Medicaid, it says.

“Between October 2020 and March 2021, Defendant knowingly submitted to the Montana Medicaid program multiple misleading claims pursuant to a common scheme,” the affidavit says. “Defendant represented in these claims that she was providing individual psychotherapy to (the children), both of whom are Medicaid beneficiaries. However, Defendant was in fact providing different services which were not eligible for reimbursement by Medicaid.”

During her June 1 sentencing hearing, District Court Judge Mike Menahan ordered her to pay $2,501.82 plus $180 in fees.

The charge will be dismissed in six months if she meets the conditions of the deferred sentence agreement. As part of the agreement, she is subject to all rules and regulations of Adult Probation and Parole and is prohibited from certain activities such as gambling and possessing firearms.

Editor Jesse Chaney can be reached at 406-447-4074, or find him on Twitter: @IR_JesseChaney. 

 
 

Clipped from: https://helenair.com/news/local/crime-and-courts/helena-clinical-counselor-pleads-guilty-to-felony-medicaid-fraud/article_296e4c18-9274-5af2-9cfe-e196de358988.html

MM Curator summary

[MM Curator Summary]: Mostly for a service-not-provided scam between 2017 and 2019.

 
 

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

Rebecca Fruge Anderson, a qualified service provider, was audited and found to have fraudulently over-billed on Medicaid care, including for services she did not provide, between 2017 and 2019, according to authorities.

 
 

BISMARCK — A Mandan woman must pay $75,904 in restitution to the state of North Dakota after pleading guilty to Medicaid fraud, according to state Attorney General Drew Wrigley.

Rebecca Fruge Anderson pleaded guilty to the felony charge in November 2021.

Anderson, a qualified service provider, was audited and found to have fraudulently over-billed on Medicaid care, including for services she did not provide, between 2017 and 2019, Wrigley’s office said in a statement Thursday, June 9.

“Rebecca Anderson fraudulently billed and received more than $75,000 from the Medicaid program,” Wrigley said.

In addition to the $75,904.95 restitution, Anderson received a two-year suspended jail sentence, three years of supervised probation and was ordered to pay $810 in court fees.

The case was investigated and prosecuted by the Medicaid Fraud Control Unit of the North Dakota Attorney General’s Office with help from the state Department of Human Services’ Program Integrity Unit.

 
 

Clipped from: https://www.jamestownsun.com/news/north-dakota/north-dakota-woman-ordered-to-pay-75k-in-medicaid-fraud-case

MM Curator summary

[MM Curator Summary]: They juiced the pricing and the shipping charges to get $363k more than they should have.

 
 

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

 
 

OKLAHOMA CITY – Attorney General John O’Connor announced today that a former Oklahoma-based company, Tri State Medical Supplies, LLC, has agreed to resolve allegations that the company violated the Oklahoma Medicaid False Claims Act by inflating prices and shipping charges of durable medical equipment. Tri-State Medical Supplies has agreed to pay $363,116 to resolve the allegations.

Tri-State Medical Supplies provided durable medical equipment and other services to Oklahoma Medicaid beneficiaries through a program administered by the Oklahoma Department of Human Services Developmental Disabilities Services Division. The settlement resolves certain allegations that Tri-State submitted claims to the Oklahoma Medicaid program, known as “SoonerCare,” based on inflated pricing and shipping charges.

“The Oklahoma attorney general’s office will always aggressively investigate these cases and partner with our local, state and federal agencies to ensure those who commit Medicaid and Medicare fraud are held accountable,” said Attorney General O’Connor.

The Oklahoma Medicaid Fraud Control Unit (MFCU) began investigating Tri-State after receiving a referral from a program manager at OKDHS Developmental Disabilities Services Division (DDSD). The DDSD works with clients who are physically challenged. The program manager became suspicious when the claims of Tri-State were compared to claims from other companies that provided similar services and equipment.

“I commend our Medicaid Fraud Control Unit for successfully investigating this case and OKDHS Developmental Disabilities Services Division (DDSD) for their employee’s referral,” said Attorney John O’Connor.

The Oklahoma Attorney General’s Office Medicaid Fraud Control Unit has statewide jurisdiction to investigate and prosecute violations of state and federal laws pertaining to provider fraud in the administration of the Oklahoma Medicaid program. Additionally, the MFCU investigates and prosecutes qui tam, or “whistleblower” allegations in Oklahoma and nation-wide, and frequently partners with other states’ MFCUs and United States Attorneys’ offices.

The MFCU also investigates and prosecutes cases of abuse, neglect, drug diversion, and financial exploitation involving residents in long-term board and care facilities, as well as, in some circumstances, residential care settings.  In this role, the MFCU serves as a safeguard against caretakers who abuse, neglect, or exploit vulnerable Oklahomans.

 
 

Clipped from: https://newstalkkzrg.com/2022/06/10/oklahoma-company-inflated-prices-for-medicaid-equipment/

MM Curator summary

[MM Curator Summary]: Leslie Lassen falsified eligibility information to hide her income and stole $350k in benefits in this member fraud.

 
 

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

 
 

Leslie K. Lassen

An extensive investigation has led to the arrest of a Linden woman, Union County Prosecutor William A. Daniel announced Wednesday.  The criminal complaint comes as the result of a nearly two-year investigation led by Detective Alex Lopez of the Union County Prosecutor’s Office’s Special Prosecutions Unit.  Leslie K. Lassen, 39, was charged on May 23^rd with one count of second-degree theft and two counts of third-degree tampering with records in connection with the scheme.

In June of 2020, the Prosecutor’s Office received a referral from the New Jersey Medicaid Fraud Division pertaining to the theft of Medicaid funds by Lassen, said Assistant Prosecutor Melissa Spagnoli, who is handling the case.  The exhaustive investigation that followed revealed that between January 2015 and December 2019, Lassen filed numerous falsified documents with Medicaid in which she under-reported her household income.  Based upon those fraudulent submissions, Lassen stole nearly $350,000 in public funds that she wasn’t entitled to.

 “I am grateful to the members of the Prosecutor’s Office’s Special Prosecutions Unit for their diligence and dedication throughout this investigation,” said Prosecutor Daniel. “Our commitment to stem a rising wave of fraud and financial crime — particularly that which targets public funds needed by our most vulnerable citizens — remains unwavering. 

Convictions on second-degree criminal charges are commonly punishable by 5 to 10 years and those on third-degree crimes can result in 3 to 5 years.

These criminal charges are mere accusations. Each defendant is presumed innocent unless and until proven guilty in a court of law.

 
 

Clipped from: https://ucnj.org/prosecutor/press-releases/prosecutor/2022/06/01/linden-woman-charged-in-a-years-long-medicaid-fraud-scheme/

MM Curator summary

[MM Curator Summary]: Josh Maywalt used his role as a medical biller to file false claims and send them to a bank account he owned. You lost $2M in tax dollars.

 
 

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

Crime & Safety

Prosecutors said the fraud occurred when Joshua Maywalt worked as a medical billing company in Clearwater.

 
 

D’Ann Lawrence White,

Patch Staff

 
 

Posted Mon, Jun 6, 2022 at 11:33 am ET

 
 

Prosecutors said the fraud occurred when Joshua Maywalt worked as a medical billing company in Clearwater. (Shutterstock)

TAMPA, FL — A 42-year-old Tampa man has been sentenced to five years, five months in federal prison for health care fraud, aggravated identity theft, filing a false income tax return and failing to file an income tax return.

U.S. District Judge Mary S. Scriven also ordered Joshua Maywalt to forfeit $2,257,029.86 and real property at 5346 Northdale Boulevard in Tampa, which can be traced to proceeds of his crimes.

Maywalt pleaded guilty on Dec. 1.

Find out what’s happening in Tampawith free, real-time updates from Patch.

According to court documents, Maywalt worked as a medical biller at a company in Clearwater that provided credentialing and medical billing services for its medical provider clients. In this capacity, Maywalt had access to the company’s financial, medical provider and patient information.

Maywalt was assigned to a Tampa Bay area physician’s account and was responsible for submitting claims to Florida Medicaid Health Maintenance Organizations for services rendered by the account to Medicaid recipients.

Find out what’s happening in Tampawith free, real-time updates from Patch.

According to prosecutors, Maywalt abused his role as a medical biller by wrongfully accessing and using the company’s patient information and account identification number to submit false and fraudulent claims to a Florida Medicaid HMO for medical services which were not actually rendered.

Maywalt also altered the “pay to” information associated with the HMO’s payment processor so the payments for the non-rendered medical services were sent to bank accounts under Maywalt’s control.

Prosecutors said Maywalt also signed and filed a false federal income tax return 2019 which substantially understated his income and reported only his employment wages, and not the money he was depositing into his bank accounts as a result of his fraudulent activities.

In addition, prosecutors said Maywalt failed to file federal income tax returns for 2017 and 2018.

“Health care industry professionals are required to follow Medicaid rules and accurately bill for services that are actually provided. Fraudulently billing Medicaid for personal gain cheats millions of people who fund the program and contributes to the soaring cost of health care,” said Omar Perez Aybar, special agent in charge with the Department of Health and Human Services. “Working closely with our law enforcement partners, we will continue to pursue those who exploit government health care programs.”

“Joshua Maywalt had no concern for anyone except himself. He exploited the personal information of medical patients, fraudulently billed services on behalf of a local physician and then cheated the U.S. tax system for his own personal gain,” said Brian Payne, special agent in charge of the IRS Tampa Field Office. “In the end, committing fraud doesn’t pay. In this case, it resulted in a five-year prison sentence and a multimillion dollar forfeiture order.”

Clipped from: https://patch.com/florida/southtampa/prison-time-handed-down-tampa-man-convicted-medicaid-fraud