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Attorney General's News Release

June 29, 2010

Attorney General Koster lauds decision in Missouri Supreme Court case -- Court upholds Medicaid fraud judgment --

Jefferson City, MO - The Supreme Court of Missouri today affirmed the St. Louis County Circuit Court's award of summary judgment against Stephanie Spilton for more than $1.8 million. Spilton, a licensed clinical social worker, was alleged to have submitted more than 300 false claims to the Medicaid program for therapy sessions that she never actually provided.

The Medicaid program processes a huge volume of claims and relies on the honesty and integrity of its providers to process claims quickly and accurately. The court held that the award of civil penalties -- $5,000-$10,000 for each "knowing violation" of Missouri's Medicaid Fraud statute, was appropriate.  The language of the statute "...clearly puts all individuals on notice that if they violate [the statute], they will be liable for at least $5,000 per violation." The court also rejected Spilton's argument that the penalties were unconstitutionally excessive or void for vagueness.

"Today's Supreme Court ruling reaffirms the substantial civil remedies available to the state in Medicaid fraud cases," Attorney General Chris Koster said.  "The decision also is a reminder that the Attorney General's office will continue to move aggressively against those who commit Medicaid fraud."

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