Woman sentenced for filing false medicaid claims

Michigan Attorney General Bill Schuette last Thursday announced that Lajuana Scott, 59, of Detroit, was sentenced to one year in jail and five years on probation after she was convicted of three felony counts: Embezzlement from a Non-Profit or Charitable Organization, Health Care Fraud – False Claim, and Medicaid Fraud – False Claim.

Scott was sentenced on Wednesday, May 30, before Ingham County Circuit Court Judge Clinton Canady III. Scott was also ordered to pay $915,000 in restitution.

“Not only did this non-profit employee steal nearly one million dollars, but she stole from the taxpayers by falsely billing Medicaid and Medicare from a non-profit tasked with helping those to fight drug addictions,” Schuette said. “I will continue to seek justice for the taxpayers of this great state by aggressively prosecuting individuals who steal from them.”

The attorney general’s Health Care Fraud Division (HCFD) conducted an investigation into Scott’s activities as a biller at Nardin Park Recovery Center in Detroit. Nardin Park Recovery Center is a non-profit corporation and licensed methadone clinic. Scott came to the attention of the HCFD through the use of “data mining” when a claims data query by the HCFD identified Nardin Park as a provider billing Medicaid and Medicare for suspicious claims.

The HCFD learned that Scott was submitting false claims for psychotherapy to Medicaid and Medicare – she was billing multiple entities for the same psychotherapy services provided to Nardin Park patients, as well as billing on behalf of doctors who had not provided therapy to the patients. During the investigation, the HCFD also learned that Scott was stealing money from the non-profit’s bank account by withdrawing funds from an ATM at a Detroit casino and gambling with the money.

The Health Care Fraud Division is tasked by the attorney general with identifying, prosecuting, and preventing fraudulent activity by doctors, dentists, pharmacists, and other health care providers participating in the Medicaid program. The Health Care Fraud Division also investigates and prosecutes abuse and/or neglect of residents in long-term care facilities, like nursing homes. Cases involving misappropriation of patient trust funds and identity theft in resident care facilities are also investigated.

The Health Care Fraud Division’s 24-Hour Hotline is 800-24-ABUSE (800-242-2873).