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Employees Honored For Work Leading to the Conviction of Five People For Medicaid Fraud
MADISON - Three Wisconsin Department of Justice employees were recognized today by the United States Department of Health and Human Services Office of Inspector General for their work on the Compassionate Mothers case that resulted in the conviction of five people for the fabrication of billing documents to support fraudulent Medicaid claims.
Frank Remington, Al Gutierrez and Rich Basiliere were recognized today at a ceremony in Madison conducted by LaMont Pugh, on behalf of DHHS Inspector General Daniel Levinson. Pugh, the Special Agent in Charge of the DHHS Office of Inspector General's Chicago Office of Investigations, presented the Department of Justice employees with the Inspector General Integrity Award, which is given in recognition of exemplary skills and dedication in fighting health care fraud.
Frank Remington is an Assistant Attorney General at the Wisconsin Department of Justice. Prior to joining the Department of Justice in 1988, Remington clerked with the Wisconsin Supreme Court and spent two years in private practice. He currently prosecutes Medicaid fraud and health care crimes for DOJ. Remington is also active in the State Bar of Wisconsin, currently serving on the Board of Governors.
Al Gutierrez is an investigator with the Medicaid Fraud Control Unit of the Wisconsin Department of Justice. Gutierrez joined the Department of Justice in 2003, after serving for over 25 years with the Milwaukee Police Department as a law enforcement officer, including work as a detective in the criminal investigation bureau and the vice control division.
Rich Basiliere is also an investigator with the Medicaid Fraud Control Unit of the Wisconsin Department of Justice, joining the Department in 2005. Prior to that, Basiliere was involved in the investigation of public assistance fraud at the county level for over 10 years. Basiliere served as a board member and president of the Wisconsin Association of Public Assistance Fraud.
"The lawyers and investigators of the Medicaid Fraud Control Unit investigate and prosecute fraud and elder abuse every day," Attorney General J.B. Van Hollen said. "I am proud to see Frank, Al, and Rich honored for their hard work on a very large and significant case. They deserve it."
The Department of Justice prosecuted a series of cases regarding Compassionate Mothers Inc. Nicole Stewart founded Compassionate Mothers Inc. in 2003, and stated its purpose was to provide prenatal care coordination and childcare coordination for pregnant mothers or mothers with newborns less than eight months who were eligible for the Medicaid or Badgercare Program. Between September 2004 and March 2006 Stewart billed Medicaid for services that had not been provided.
In March 2006 the Department of Health and Family Services notified Stewart that it was going to conduct an audit of the business. Lacking any proof to support the billings to the Medicaid Program, Stewart paid her employees to fabricate documents in an attempt to cover up the fraudulent billings. The defendant created documents in an effort to make it appear that services were provided when, in fact, none had ever been. In addition to the cover up and billing for services that had never been provided, the complaint alleges that Stewart knowingly billed the Medicaid Program for services that had been provided but were not eligible for reimbursement under the Medical Assistance Program.
On October 22, 2007, Stewart pleaded guilty to four counts of felony Medical Assistance Fraud. Additional charges of Medical Assistance Fraud were read-in for purpose of sentencing. The additional charges stem, in part, from a separate criminal complaint filed on September 18, alleging Stewart violated conditions of bail by starting another company called Care and Comfort Support Services and using that company to file false claims to the State's Medicaid program.
Nicole Stewart was sentenced to 5 years confinement, 9 years extended supervision and 3 years probation to be served consecutively, with $320,603 owed in restitution.
In July 2007, three of the employees who assisted Stewart in creating the false documents each pleaded guilty to one misdemeanor count of filing fraudulent insurance claims. At an October 16, 2007, hearing, Judge Sosnay withheld a sentence and placed each defendant on one year probation. As a condition of probation, each defendant was ordered to pay $1,500 in restitution and a $1,000 fine.
A fourth employee, Shirlaine Baker, pleaded guilty in March 2007 to one misdemeanor charge and was ordered to pay $1,500 in restitution.
The Medicaid Fraud Control Unit served as lead investigators and prosecutors of the case. The Department of Health and Human Services Office of Inspector General also provided investigative support.
The Medicaid Fraud Control Unit of the Wisconsin Department of Justice investigates and prosecutes the abuse and neglect of elderly and others who receive Medicaid. It also investigated Medicaid billing fraud.