Illinois State Police (ISP) officials today announced a successful conviction resulting from a thorough investigation by the ISP Medicaid Fraud Control Bureau (MFCB) and aggressive prosecution by the Illinois Attorney General’s Office.
In June 2015, the ISP-MFCB received a complaint reporting Lola L. White, 53, of Shumway, Illinois, the administrator of Evergreen Nursing and Rehabilitation, Effingham, Illinois, appeared to be transferring money from an elderly person’s bank account into her personal bank account. It was reported that White was the trustee of the elderly person’s trust and had Power of Attorney over his assets. The elderly person was a resident at Evergreen Nursing and Rehabilitation. During the investigation it was discovered that White misappropriated $93,632.95 from the elderly person’s trust account and his life insurance accounts.
On April 1, 2016, White was charged with a Class 3 Felony Theft and entered a guilty plea and accepted a pre-negotiated plea agreement in which she was sentenced to 24 months of Second Chance Probation, 30 hours of community service, and $1,367.00 in court costs. The $93,632.35 in misappropriated funds was repaid in full to the elderly person’s trust account. The case against White was prosecuted by Assistant Attorney General Counsel Steve Swofford.
“The men and women of the ISP MFCB are committed to combatting fraudulent activity of those involved in the Medicaid program,” said ISP Captain Brian Ley. “Our investigators are highly motivated when an investigation involves those most vulnerable. I am very proud of the tenacity and dedication it takes to work these cases which involve financial exploitation of one’s life savings.”
This conviction comes on the heels of the state of Illinois ramping up efforts against health care based fraud. On Tuesday, Governor Rauner signed Executive Order 16-05, creating the Health Care Fraud Elimination Task Force. This Task Force will study and utilize the best practices of agency fraud prevention units, including MFCB, the efforts of the federal government and other state governments, and those in the private sector to root out fraud, waste, and abuse.
“The people of Illinois deserve protection from waste and fraud,” said Governor Rauner. “Those who cheat our state, especially by exploiting our most vulnerable, deserve to face punishment. ISP MFCB has worked diligently throughout this investigation to seek justice for taxpayers.”
The Illinois State Police Medicaid Fraud Control Bureau (MFCB) was established in 1978. The Bureau is currently comprised of sworn officers, non-sworn investigators, attorneys, analysts, and an accountant supervisor. In addition, attorneys from the Office of the Illinois Attorney General are assigned to the MFCB to prosecute cases.
The MFCB works a myriad of cases targeting fraud and abuse of the Medicaid Provider Program. The MFCB receives direction from the U.S. Department of Health and Human Services Office of Inspector General (HHS/OIG) and works with other state agencies including the Illinois Department of Healthcare and Family Services, Illinois Department of Professional Regulation, and Illinois Department of Public Health. The MFCB is a member of the National Association of Medicaid Fraud Units (NAMFCU), a professional organization made up of 50 different MFCUs. http://www.namfcu.net/
Some of the more common cases MFCB investigators work are fraudulent billing by doctors, dentists, and counselors for services not medically needed or services which were never performed; financial exploitation of the elderly; drug diversion cases including theft of controlled substances by registered nurses in nursing homes; medical transportation companies who bill for services not rendered or for more services than those which were actually performed, pharmaceutical supply companies or pharmacies which are receiving kickbacks to prescribe a certain medication; cases involving physical abuse and neglect at long-term care facilities and other institutions caring for our most vulnerable; and fraud of the Home Services Program which is a Medicaid Waiver Program.
The MFCB also investigates violations of the Illinois False Claims Act and the Federal False Claims Act in conjunction with federal investigators.
