Arkadelphia News

AG’s Medicaid fraud watchdog arrested 51, convicted 33 in fiscal year 2022

By TESS VRBIN | Arkansas Advocate

Arkansas’ Medicaid fraud watchdog saw its most active year in fiscal 2022, which ended Sept. 30, racking up 51 arrests and 33 convictions for various types of Medicaid fraud, Attorney General Leslie Rutledge announced Thursday.

The Medicaid Fraud Control Unit also brought in a record of more than $42.5 million in civil settlements, restitution and fines, Rutledge said at a news conference. The previous six fiscal years brought in a total of about $36 million.

 Arkansas Attorney General Leslie Rutledge, second from right, shares the achievements of her office’s Medicaid Fraud Control Unit with reporters Thursday morning alongside Special Agent Greg McKay (left), Special Agent Rhonda Swindle (second from left) and Lloyd Warford (right), the deputy attorney general for the Medicaid Fraud Control Unit. | Tess Vrbin/Arkansas Advocate

Rutledge praised the unit’s work as “monumental” both for its investigations and for its return on investment.

“For every dollar of government money spent, we had a return [on investment] of $13.27,” she said.

The MFCU investigates and prosecutes Medicaid fraud and the abuse, neglect and exploitation of Medicaid recipients and people who live in residential care facilities. The unit’s work has led to 185 convictions since Rutledge became attorney general in 2015, according to data provided by her office.

The 51 arrests in FY 2022 included 26 for fraud and 25 for abuse and neglect. The unit broke its FY 2018 record of 24 fraud arrests and 20 abuse and neglect arrests, according to the data.

Lloyd Warford, the deputy attorney general in charge of the MFCU, said there is “some overlap” in the charges against the people the unit arrests, and the 33 convictions in FY 2022 were 33 people, not individual charges.

A news release broke down the unit’s $42.5 million haul into $41.3 million in civil false claims settlements; $622,279 in fines; $338,662 in court-ordered restitution; $159,000 in civil penalties from eight abuse and neglect settlements; and $250,000 from settlements after joint investigations with the National Association of Medicaid Fraud Control Units and the U.S. Department of Justice.

FY 2016 saw the second-highest amount of civil false claims settlements from the fraud control unit with $9.1 million, according to the data.

The unit is made of 20 full-time employees, including attorneys, accountants, nurses and law enforcement officers, Rutledge said. Law enforcement officers were not part of the unit until Rutledge took office, she said.

There are 38 Medicaid fraud and abuse cases pending in circuit courts as of Thursday, Warford said.

“Whoever the next attorney general is, he’s likely to break this year’s record just by showing up,” Warford said.

Rutledge is running for lieutenant governor and will leave the attorney general’s office in January. She will be succeeded by either Democrat Jesse Gibson or Republican Lt. Gov. Tim Griffin.

Rutledge and Warford both mentioned the prosecution of Skyline Health Care’s former owner as an example of the effectiveness of the MFCU.

The attorney general’s office charged Joseph Schwartz of Suffern, New York, with eight Arkansas Medicaid fraud charges and two state tax violations in December 2021. Skyline is a failed national nursing home chain that operated 21 facilities in Arkansas and generated reports of neglect and abuse.

Later in December, a federal judge advised that Schwartz pay $10 million in damages to the family of a woman who died in one of his nursing homes in Little Rock in 2018.

Earlier this year, an MFCU investigation into Empower Healthcare Solutions, the state’s largest managed care provider for Arkansans with disabilities, resulted in no findings of fraud and an $8 million payment from the company to the Arkansas Medicaid program. The inspector general’s office of the U.S. Department of Health and Human Services worked with the MFCU to investigate how Empower reported its expenses in 2020 after state officials raised concerns.

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