Four People Sentenced in Milwaukee County for Medicaid Fraud

MADISON — Attorney General J.B. Van Hollen announced that four more people appeared before Milwaukee Circuit Court Judge Dennis R. Cimpl to be sentenced for crimes in a Medicaid fraud scheme related to the submission of false claims for durable medical equipment.

Those convicted on April 16 and sentenced yesterday are:

• Lynnesha Craig, 31, d/b/a Wisdom Medical Supply. Convicted on three counts of Medicaid fraud, Craig was sentenced to a total of nine years imprisonment, comprising three years initial confinement and six years extended supervision. Conditions of extended supervision include no contact with any victims, absolute sobriety and payment of $94,090.53 in restitution.

• Darius Jarrett, 40, d/b/a Great Medical Services. Convicted on three counts of Medicaid fraud, Jarrett was sentenced on the first two counts to a total of six years imprisonment, comprising two years initial confinement and four years extended supervision; on the third count a sentence of three years and six months imprisonment was imposed and stayed, and Jarrett was placed on three years probation consecutive to the first two counts. Conditions of extended supervision and probation include no contact with any victims, full-time employment and payment of $235,871.62 in restitution.

• Elizabeth Thomas, 35, d/b/a Direct Medical Supply. Convicted on four counts of Medicaid fraud, Thomas was sentenced to a total of 12 years imprisonment, comprising four years initial confinement and eight years extended supervision. Conditions of extended supervision include no contact with any of the victims, obtain an HSED or GED, and payment of $256,914.14 in restitution.

• Kimberly Thomas, 44, d/b/a Cudahy Medical Supply. Convicted on one count of Medicaid fraud, her sentence of imprisonment for three years and six months, comprising eighteen months initial confinement and two years extended supervision, was imposed and stayed. Thomas was placed on three years probation with conditions to include six months in the House of Corrections, and payment of $28,220.96 in restitution.

Previously convicted and sentenced regarding the same operation were:

• Donnis Carrington, d/b/a DC Medical Services, who was convicted on March 15 of one count of Medicaid fraud. On May 23, Judge Cimpl imposed and stayed a sentence of three and a half years imprisonment, and placed Carrington on three years probation with conditions to include six months in the House of Corrections.

• Ericka Thomas, d/b/a Ericka's Medical Supply, was convicted on April 16 of four counts of Medicaid fraud. On June 7, Judge Cimpl sentenced Thomas to 12 years imprisonment, comprising four years initial confinement and eight years extended supervision. Thomas must pay $356,366.33 in restitution to Wisconsin Medicaid.

Convicted but not yet sentenced:

• Erica Danley, 35, d/b/a Essential Services, was convicted April 16 on three counts of Medicaid fraud. Sentencing is scheduled for July 19, 2012.

According to the Department of Justice's criminal complaints, the seven defendants were engaged in a scheme to defraud Wisconsin Medicaid by the submission of claims for payment for the provision of durable medical equipment (DME) used for orthotic purposes. Medicaid is a healthcare program for the needy and disabled jointly funded by the state and federal governments. Orthotics is a branch of medicine that deals with the use of specialized mechanical devices to support weakened joints or limbs.

Each of the seven had submitted applications to Wisconsin Medicaid to become DME providers, obtained provider numbers and authorization to bill for the DME provided. Claims that followed were primarily for halo cervical devices, tension scoliosis devices, and KAFO devices used to support the knee-ankle-foot. That equipment typically requires specialized medical treatment for installation and use, but no such complementary claims from hospitals or physicians were filed.

Further investigation revealed that the recipients for whom the devices were allegedly provided did not know the providers, or have need for such orthotic devices. The total amount claimed through such billings was $1,253,816.73, but the Bureau of Public Integrity at the Wisconsin Department of Health Services was able to identify and intercept $199,747.03 before it was paid out.

The Medicaid Fraud Control and Elder Abuse Unit of the Wisconsin Department of Justice conducted the investigation that led to the filing of the seven criminal complaints. The cases are being prosecuted by Assistant Attorney General Thomas Storm. Amy Severt of the Office of Crime Victim Services provided victim assistance.