Attorney General's News Release

January 19, 2012

Attorney General Koster’s Medicaid Fraud Unit collected more than $20 million in 2011

Jefferson City, Mo.— Attorney General Chris Koster said his office collected more than $20 million and took action against 26 providers for Medicaid fraud in 2011. In the past three years, the Attorney General’s Office has collected almost $150 million in Medicaid fraud recoveries.

Koster’s Medicaid Fraud Control Unit is a national leader in cost-effectiveness. According to the latest available data from the U.S. Department of Health and Human Services, the Missouri Medicaid Fraud Control Unit collected more than $31.00 for each dollar spent in federal fiscal year 2010, the highest ratio in the nation. In the previous two years, Missouri was No. 2 in the nation in recoveries per grant dollar.

According to Koster, last year his office:

• Resolved criminal matters regarding 11 medical and home health care providers. Two individuals are currently serving prison time, and seven others will serve prison time if they do not meet all the terms of their probation. In the other two cases, the Attorney General’s Office was able to negotiate settlements with the individuals.
• Resolved civil cases against 15 providers, including Beverly Hills Pharmacy in St. Louis, which was found to have routinely submitted unlawful claims to the Medicaid program. Beverly Hills Pharmacy paid the state $500,000 in a settlement.

“My office is committed to aggressively pursuing medical and home health care providers who are stealing from the taxpayers of Missouri by committing Medicaid fraud,” Koster said. “Our criminal prosecutions and our recoveries of large sums of money serve as a warning to providers who would consider submitting false bills to Medicaid: we are watching, and you will not get away with it.”

Koster’s office also takes action against individuals who abuse Medicaid recipients. The office filed criminal charges against Christopher Mayo, who pleaded guilty last May to having physically abused a Medicaid recipient residing in a Marion County skilled nursing facility. Mayo is now serving five years in prison.

Koster said he encourages individuals to report suspected Medicaid fraud to his office. As part of outreach efforts to identify and prosecute Medicaid fraud, Koster taped a public service announcement asking citizens to report fraud to his office and informing them that state law allows whistleblowers 10 percent of any Medicaid fraud money recovered as a result of their tip. The PSA can be viewed at: http://www.youtube.com/watch?v=Ulc__bnFMPI&feature=youtu.be.

Missourians can report suspected Medicaid fraud and abuse online at ago.mo.gov or through the Medicaid Fraud Hotline at 800-286-3932.