Fraudulent Medicaid Applications Result in Criminal Guilty Plea

A former public administrator in Montana pleaded guilty in federal court to creating fraudulent Medicaid applications.

Rita Frances Hunter admitted that she directed employees to submit materially false Medicaid applications for wards in the custody of the Public Administrator’s office. The applications falsely stated that the wards had assets below the $1,000 threshold to be eligible to receive Medicaid benefits when, in fact, the wards had more than $1,000 in assets.

In one instance, a fraudulent Medicaid eligibility statement indicated that the ward had a total bank account balance of $827.27 when the ward’s funds totaled $6,919.  The false statement was made to ensure that the ward would meet the monetary threshold (no more than $1,000) imposed by Medicaid.

Hunter caused this statement to be stamped with her signature verifying that it was true, when in fact it was false.  She also instructed her employees to fabricate bank statements to back up the false claim.

Under federal statutes, submitting false applications to Medicaid may result in a prison sentence of up to five years without parole, plus a fine up to $250,000 and an order of restitution.  A sentencing hearing will be scheduled in this case after the U.S. Probation Office completes a pre-sentence investigation and report.

A health care fraud investigation can have serious consequences, but you may have options.  The government may be relying on faulty or inaccurate information.  Or there may be an opportunity to minimize the charges and penalties by cooperating with government investigators.  Each case is different and requires a thorough investigation to develop your defense.

If you are under investigation or have been charged with a crime, then you should consult with an experienced healthcare fraud defense lawyer immediately to protect your rights.  To schedule a free and confidential consultation by telephone or in person, call my office today at (917) 652-6504 or click here to communicate with me via email.

John Howley
New York, New York

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