Attorney General Andy Beshear and his Office of Medicaid Fraud and Abuse today announced the guilty pleas of a London mom and a caretaker who defrauded Kentucky’s Medicaid program out of thousands of dollars meant to fund care for the mom’s son.
Angelia Rawlings, 42, of London, submitted more than $1,200 in false receipts for health care items to the Cumberland Valley Area Development District, to be reimbursed by Medicaid.
Janice Mosley, 47, of London, submitted 10 months of fraudulent timesheets totaling more than $4,500 to Cumberland Valley Area Development District as a Consumer Directed Option (CDO) employee for Rawlings’ son. From April until December 2014, Mosley submitted timesheets that reflected conflicts with time Rawlings’ son was attending school full-time.
Kentuckians may chose treatment through the state’s Consumer Directed Option that allows area agencies to contract as caseworkers for the state to manage treatment for non-medical services.
Rawlings pleaded guilty to two counts of theft by unlawful taking over $500 and two counts of Kentucky Medical Assistance Fraud of $300 or more. In exchange for Rawlings’ plea of guilty, the Commonwealth recommended three years on each count, to run concurrent, diverted (probation) for a period of three years.
As a condition of diversion, Rawlings will pay $5,787.28 – $1,266.08 for which she is solely responsible and $4,521.20 for which she is jointly and severally liable with co-defendant Mosley.
According to the plea, Rawlings will pay the $1,266.08 at the time of sentencing on June 22, 2018, in Franklin Circuit Court. Lastly, Rawlings will enter an agreement to be excluded from all federally funded health care programs and will not participate as a provider in the Kentucky Medicaid System for a minimum of five years.
As part of her plea, Mosley pleaded guilty to one count of theft by unlawful taking over $500 and one count of Kentucky Medical Assistance Fraud of $300 or more. In exchange for Mosley’s plea of guilty, the Commonwealth recommended two years on each count, to run concurrent, diverted (probation) for three years.
As a condition of diversion, Mosley will pay $4,521.20 at the time of sentencing May 25, 2018, in Franklin Circuit Court. She will enter an agreement to be excluded from all federally funded health care programs and will not participate as a provider in the Kentucky Medicaid System for a minimum of five years.
The Kentucky Attorney General’s Office of Medicaid Fraud and Abuse and the Cabinet for Health and Family Services, Office of the Inspector General investigated the case, and Assistant Attorney General Ashley Kennedy prosecuted the case.
To date, efforts by Beshear’s office through civil settlements and criminal restitution resulted in over $71 million in obligations to the state and federal Medicaid program, Medicare, Tricare, commercial payers and other entities.
The Attorney General’s tip line for reporting allegations of Medicaid fraud is 877-ABUSE TIP.