Personal Care Attendant Gets Jail Time for Fraudulently Billing Medicaid $20,569
September 12, 2014
The Medicaid Fraud Control Unit (MFCU) successfully prosecuted 59 year old Jong H. Choi for falsely billing Medicaid for personal care attendant (PCA) services when he was not authorized to bill Medicaid. MFCU investigators interviewed Choi’s wife regarding bills submitted to Medicaid while she was out of the country and/or caring for other recipients. MFCU investigators learned that Choi was forging his wife’s name on timesheets submitted to Medicaid for services he was allegedly providing despite being barred by Medicaid from providing services due to a prior criminal conviction. Choi forged his wife’s name on a total of $20,569.00 in Medicaid bills which were paid by Medicaid. Choi also submitted $46,875 in Medicaid bills in 2010 under his own name after being notified by Medicaid that he was barred from billing Medicaid until October 28, 2013. The case was jointly investigated by the MFCU, the Department of Health and Social Services and Immigration and Customs Enforcement.
PCAs are enrolled with Medicaid as health care providers that the Alaska Medicaid Program pays to provide Medicaid recipients with assistance in activities of daily living, which allow Medicaid recipients to stay in their home rather than be placed in a nursing home type setting. The PCAs are required to successfully pass a background check, complete annual training and meet with a recipient’s care coordinator to fully understand the recipient’s plan of care outlining service needs. State law prohibits the submission of false timesheets and/or claims for PCA services being provided by individuals that are not enrolled with Medicaid.
Based on the aforementioned evidence, Jong Choi was convicted on September 12, 2014 for one count of Medical Assistance Fraud, a C Felony, for knowingly submitting claims to a medical assistance agency with a reckless disregard that the claimant was entitled to the payment. He was also convicted fora single count of submitting false medical records to a medical assistance agency. Choi was sentenced to serve 20 months in jail with 18 months suspended and five years of formal probations. The court also ordered Choi to pay restitution of $67,435.59 (the full amount paid by Alaska Medicaid as a result of Choi’s conduct) and perform 160 hours of community work service. Choi will be permanently barred from billing Medicaid as a result of this conviction and will be placed on a nationwide exclusion list.
The Alaska MFCU is part of the Attorney General’s Office. The MFCU is responsible for investigating and prosecuting Medicaid fraud and abuse, neglect or financial exploitations of patients in any facility that accepts Medicaid funds. The information filed in each case can be found on the MFCU website. This is just one of 66 cases successfully prosecuted by the MFCU since October 2012.
CONTACT: Assistant Attorney General Andrew Peterson at 907-269-6292. For more information about the Choi case or other cases handled by the Alaska MFCU, go to the MFCU website.
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