South Carolina: $9 Million Health Care Fraud Busted Thanks to a Whistleblower

medicaid fraudI’m posting just a bit of this news from Columbia, SC as a follow-up to the post I wrote a few days ago about the False Claims Act and because I want to encourage readers to be proactive in looking for Medicare and Medicaid fraud where you live.

SC woman charged in alleged $9 million fraud involving autism care


Federal authorities are seeking to recover $9 million that they say a S.C. woman stole in a wide-ranging scheme involving false medical bills for treating autistic children.
Susan A. Butler, the “founder” of the S.C. Early Autism Project, is charged with overbilling Tricare and Medicaid, two federal health insurers, and making false claims about patient services. Money the insurers paid for patient care instead went for administrative costs, according to a federal grand jury indictment made public Wednesday.

You can read more about Ms. Butler, but this is the part I want you to see.

In August, the U.S. Attorney’s office in Columbia announced the Early Autism Project had paid $8.8 million to settle a civil case under the False Claims Act, alleging it had submitted false claims to Tricare and the S.C. Medicaid program for children with autism.
…in the August press release, the U.S. attorney’s office in Columbia said the case began when a whistleblower, former Early Autism Project employee Olivia Zeigler, brought the allegations to the government’s attention.
Under the False Claims Act, a whistleblower can file a lawsuit on behalf of the government. If the government gets involved and recovers money, the whistleblower gets part of any settlement. Zeigler was paid $435,000, the U.S. attorney’s office said.

More here.
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If you want to report suspected fraud in any program involving the Dept. of Health and Human Services (Medicare, Medicaid, Refugee agency contracts (!)) go here.
Or, go back to my post on the False Claims Act and see what steps you need to take as a whistleblower filing a qui-tam case.

question markWhat can you do?

If you suspect fraud, it is your duty to do something! (And, heck you might even be rewarded as Ms. Zeigler was!).
Just reading news and shaking your head about it is downright lazy!  Do something, even if it is only to share the news within a circle of friends and family! 

Nevada: Illegal Alien is Prime Suspect in Recent Murder Spree

Wilbur Ernesto Martinez-Guzman, 19, has been arrested and is expected to be charged in several murders of senior citizens in recent weeks in the Carson City, NV area.
From KOLO 8 (an ABC affiliate) (hat tip: TwoLaine):
The elderly are resting easier in Nevada, but should they?

Murder charges expected against suspect in killings

RENO, Nev. (KOLO) – A man apparently in the United States illegally is the primary suspect in four Northern Nevada murders, and no one else is being sought.
January 20, 2019, Washoe County Sheriff Darin Balaam hosted a multi-agency news conference to announce the arrest of 19-year-old Wilbur Ernesto Martinez-Guzman. Carson City Sheriff Ken Furlong says the suspect had lived in the Carson City area about a year, but has no local record.

nevada killer
Prime suspect in killing spree of senior citizens Wilbur Ernesto Martinez-Guzman

The suspect is so far charged with burglary, possession of stolen property and obtaining money by false pretenses, and he is on an immigration hold. District Attorneys from Washoe County and Douglas County hope to file murder charges against him in the coming days, saying there is enough evidence to support such charges.
The suspect was taken into custody Saturday, January 19, 2019 in Carson City. Carson City Sheriff Ken Furlong says he was arrested on an immigration charge after being rammed by deputies on Carson Street in the Carson Mall parking lot. The suspect had already been identified as a person of interest through the investigation and tips from the public, and had been under surveillance. That operation involved several Carson City neighborhoods.


Were they murdered in their beds?


No information about a possible motive for the killings has been offered.
The first killing took place January 9 or 10, 2019. 56-year-old Connie Koontz was found shot to death at her home in the Gardnerville Ranchos.
January 13, 74-year-old Sophia Renken was found dead in her home about a mile away, also shot to death.
January 16, the bodies of 81-year-old Gerald David, a former Reno Rodeo President, and his wife, 80-year-old Sharon David, were found dead in their home on La Guardia Lane in south Reno, near Zolezzi. They also had been shot to death.

More here. Be sure to watch the news clip!
The reporter says they don’t want to put out a lot of publicity that might taint the jury pool.  What the heck!  This should be a national news story.  As of this writing I only see it mentioned in Nevada media.
By the way, no mention of his nationality yet. (If anyone sees that let me know!).

I guess we are going to have angel children joining angel moms!
This is what you need to do.  Get this story out as widely as possible. The President needs to know about it!