Milwaukee Woman Convicted of Medicaid Fraud

MADISON — Attorney General J.B. Van Hollen announced today that a Milwaukee woman has been convicted of Medicaid fraud related to the submission of claims for durable medical equipment.

Donnis Carrington, of 8731 West Herbert Avenue, Milwaukee, appeared in court yesterday and entered a plea of guilty to medical assistance fraud, a felony with a maximum potential penalty of imprisonment for six years, a fine of $25,000, or both. Two counts of identity theft were read in to the record for consideration at sentencing. The court ordered a presentence investigation and scheduled sentencing for May 23, 2012.

According to the criminal complaint, the defendant submitted claims to Wisconsin Medicaid for payment for the provision of durable medical equipment (DME) used for orthotic purposes. Orthotics is a branch of medicine that deals with the use of specialized mechanical devices to support weakened joints or limbs. Medicaid is a healthcare program for the needy and disabled jointly funded by the state and federal governments.

The complaint states that Carrington submitted an application to become a DME provider, obtained a provider number and authorization to bill for DME provided. The claims that followed were 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 were filed. Further investigation revealed that the recipients for whom the devices were allegedly provided did not know Carrington, nor did they have need for such orthotic devices. The fraudulent claims totaled $32,250.00.

The case is being prosecuted by Assistant Attorney General Thomas Storm