Restitution ordered in Medicaid fraud cases

The OIG’s Benefits Program Integrity Division resolved a case in which a client repeatedly failed to report an income-earning family member.

On four separate occasions, the client failed to report her husband as a household member, which excluded his income in the calculation for benefit eligibility and resulted in an overpayment. The investigation was completed and submitted to the Haskell County District Attorney’s office. The client was charged with Medicaid fraud. This summer, a judge ordered the client to pay restitution in the amount of $20,457, and the client was also placed on 10 years of deferred adjudication probation.

In another example of fraudulently obtained benefits, BPI resolved a case with the Hidalgo County District Attorney involving a client who fraudulently obtained SNAP and Medicaid benefits. The client submitted falsified applications by failing to include her husband as part of her household composition and his income from November 2015 to November 2017.

The client was charged with theft, ordered to pay $25,097, disqualified from receiving SNAP benefits, and placed on probation for five years.

You can read more about the OIG’s work to fight fraud, waste and abuse by reading our latest Quarterly Report: https://tinyurl.com/y5xeotja