$25 million recovered in Medicaid fraud cases

The Missouri Attorney General's Office released data showing it had recovered more than $25 million for state taxpayers through Medicaid fraud convictions.

Attorney General Eric Schmitt's office obtained 30 indictments and completed 29 convictions through it's Medicaid Fraud Control Unit (MFCU).

The unit has two principal objectives, according to the Attorney General's website: to investigate allegations of fraud committed by Medicaid members and to investigate and prosecute allegations of abuse or neglect in Medicaid-funded facilities.

During 2019, the MFCU filed 30 cases (up from 18 in 2018). The convictions are an increase from only six in 2018.

Between Jan. 1 and Dec. 4 this year, the agency recovered $10,012,400 from offenders (while only having recovered $220,800 in 2018). It also had eight civil settlements that resulted in $15,205,300 in recoveries (having received $9.1 million last year).

Cases ranged from $1,000 in home-services fraud, to million-dollar-plus cases prosecuted through the U.S. Attorney's Office, according to Chris Nuelle, press secretary for the state Attorney General's Office.

In January, Missouri was part of a $269.2 million settlement with Walgreens and Walgreens Boots Alliance (the parent company for Walgreens) over distribution of unneeded insulin pens and concealing from Medicaid lower drug prices it offered in a discount program.

Missouri was also part of a multi-state settlement with Reckitt Benckiser Group, for improper marketing and promotion of Suboxone (an opioid addition treatment drug) resulting in improper Medicaid expenditures. The state retrieved more than $4.3 million through the settlement.

Among individuals convicted for Medicaid fraud was a former Mount Vernon dentist, Thomas Alms Jr. Alms was ordered to pay $200,000 in restitution after his conviction for Medicaid fraud.

Jackson County personal care agency owner Donna Dixon pleaded guilty to Medicaid fraud, received a sentence of 60 months of probation, and is required to return $8,200 to the Medicaid program.

Vickie Heard, of Boone County, filed false time sheets with MO HealthNet that said she had done work that was not done. She's required to return $8,700.

A federal judge sentenced Pamela Van Drie, a Marshfield dental clinic owner, to four years and nine months in prison and ordered her to repay $1.1 million for Medicaid payments her clinic received. She and her husband billed Medicaid for speech aid prosthetics they did not provide to Medicaid beneficiaries.

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