AGING AND DISABILITY SERVICES ADMINISTRATION
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Completed Case Referral Actions
The following information identifies prosecution activities during the months of October through December 2003, pertaining to suspected cases of Medicaid fraud referred to the Office of the Attorney General of Washington/Medicaid Fraud Control Unit by the Department of Social and Health Services.
KING COUNTY
State v. Branch and Villa Health Care Center, Inc. (King County) Branch entered a plea of guilty on June 19 to the charge of Failure to Maintain Trust Funds in Separate Account. Immediately afterwards, Branch Villa Health Care Center, Inc., entered a plea of guilty to the charge of Medicaid False Statement. They were sentenced on December 19, 2003. Defendant Branch was sentenced to 30 days in jail converted to 240 hours of community service and Branch Villa, Inc. was sentenced to pay $318,000 in restitution. Assistance in this investigation was rendered by the DSHS/Nursing Rates Section.
State v. Beck (King County) Beck pled guilty to Theft in the First Degree on December 16, 2003 for receiving approximately $11,000 due to fraudulent billing. Sentencing is set for January 16, 2004. This matter was referred to the MFCU by DSHS/Payment Review Program and Office of Financial Recovery.
State v. Ball (King County) An information alleging one count of Theft in the First Degree and one count of Medicaid False Statement was filed December 10, 2003, against Ball because defendant continued to bill Medicaid for several months, alleging she was providing services for an individual who had died. Ball received approximately $3,300 due to her fraudulent billing. This matter was referred to the MFCU by DSHS/Payment Review Program and Office of Financial Recovery.
State v. Williams (King County) An information alleging one count of Theft in the First Degree and three counts of Medicaid Fraud False Statement was filed December 10, 2003, against Williams because the defendant billed Medicaid, for six months, allegedly providing services when he did not. Williams received approximately $6,100 due to his fraudulent billing. Arraignment is set for December 22, 2003. This matter was referred to the MFCU by Todd Wilday, DSHS/DDD.
State v. Cirsone (King County) On October 20, 2003, Cirsone pled guilty to Theft in the First Degree and on November 7, she was sentenced to 15 days in jail, 14 days converted to 112 hours of community service (the state asked for 30 days in jail), $7,235 in restitution and another $500 in costs. Crisone billed and was paid for services she did not provide. This matter was referred to the MFCU by Aging and Disability Services, Seattle.
State v. Hoi Lee, D.D.S. (King County) Dr. Lee was charged with One Count of Theft in the First Degree and One Count of Medicaid False Statement for fraudulently billing Medicaid for dental procedures he did not perform. On 9 January 2004, Dr. Lee was sentenced to six months home detention and court ordered to pay $175,000.00 in restitution. This matter was referred to the MFCU by the DSHS/Information Service Division/Payment Review and Audit Section subsequent to an audit conducted by that section.
SNOHOMISH COUNTY
State v. Lundberg (Snohomish County) After pleading guilty to Theft in the First Degree, on December 15, 2003 the defendant was sentenced to 30 days in jail, 29 days converted to 232 hours of community service, $4,402.50 in restitution and another $500 in costs. Lundberg billed and was paid for services he did not provide. This matter was referred to the MFCU by DSHS/Payment Review Program and Office of Financial Recovery.
State v. Morse - (Snohomish County) On October 6, 2003 this defendant was charged with One Count of Theft in the First Degree and Two Counts of Medicaid False Statement for continuing to bill for services provided to a deceased individual. This matter was referred to the MFCU by Bruce DeYoung, DSHS/AASA.
THURSTON COUNTY
State v. Mann (Thurston County) An information alleging one Count of Theft in the First Degree and two Counts of Medicaid False Statement was filed December 4, 2003, against Mann because defendant continued to bill Medicaid for several months, alleging she was providing services for an individual who had been hospitalized. Mann received approximately $3,500 due to her fraudulent billing. This matter was referred to the MFCU by DSHS Complaint Investigator Glenda Specht.
GRAYS HARBOR COUNTY
State v. Beauchene (Grays Harbor County) Beauchene was charged with One Count of Theft in the First Degree and Two Counts of Medicaid False Statement for billing Medicaid for almost $6,000 for providing services to an individual who had died. This matter was referred to the MFCU by DSHS/Payment Review Program and Office of Financial Recovery.
SPOKANE COUNTY
State v. Weissig (Spokane County) On November 13, 2003, Weissig pled guilty to one Count of Theft in the First Degree and one Count of Medicaid False Statement, and was sentenced to 30 days in jail, converted to community service, and ordered to pay $4,956 in restitution and another $700 in fines and costs. Weissig billed Medicaid for services she did not provide. This matter was referred to the MFCU by Aging and Long Term Care, Spokane.
LEWIS COUNTY
State v. Allmon (Lewis County) On October 15 the defendant pled guilty to One Count of Theft in the First Degree and One Count of Medicaid False Statement and was sentenced to 30 days in jail, converted to community service, and required to pay $5,250 in restitution and another $2,000 in fines and costs. This matter was referred to the MFCU by Mary Tierney and Joan Hillier, DSHS/AASA.
* Note: The MFCU has a no cost, two hour interactive training presentation, which addresses provider fraud and elder abuse identification and reporting. If your department is interested in receiving this training please contact the MFCU at (253) 593-2154/2317/2262.
