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Posts tagged: Medicaid fraud

State appeals dismissal of Medicaid provider fraud case

Here's a news item from the Associated Press: POCATELLO, Idaho (AP) — The Idaho Department of Health and Welfare is appealing a decision by an administrative judge to dismiss fraud charges and restore the Medicaid provider status of a southern Idaho mental health provider. Agency officials announced an appeal this week in the case involving Seasons of Hope. Last month, a hearing judge cleared the clinic of fraud alleged by the agency after an 18-month investigation. State lawyers accused the Chubbuck-based provider of inappropriate billing and also sought to recoup more than $439,000 in overpayments. The judge, however, did order Seasons of Hope to repay more than $94,000 in payments and fines, saying there was evidence of billing mistakes, but not fraud. But agency spokesman Tom Shanahan says agency attorneys believe the clinic owes taxpayers more than that amount.

Click below for a full report from the AP.

Medicaid fraud lands provider behind bars

A personal care provider in Bonners Ferry has received a five-year prison term and a $5,000 fine for Medicaid provider fraud, though a 1st District judge suspended the sentence and ordered Coral Mouser to serve 45 days in jail and pay $12,465 in restitution to the state Department of Health and Welfare. Mouser pleaded guilty in May, admitting submitting progress notes on care for clients in their homes that she actually didn’t provide, triggering fraudulent payments to her. The case was investigated by the Idaho Attorney General’s Medicaid fraud control unit, and prosecuted by Deputy Attorney General Kendal McDevitt at the request of the Boundary County prosecutor.

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Betsy Z. Russell covers Idaho news from The Spokesman-Review's bureau in Boise.

Named best state-based political blog in Idaho for 2013 by The Fix

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