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Prior Conviction

Healthcare-8
Senior Director of Strategic Alliances
LexisNexis Risk Solutions - Government

Maybe the kind of businesswoman Barbara Martin actually was could have been figured out by the actions behind her application to be a Medicaid provider in 2013. Martin had falsely listed her daughter, Zamika Walls, on the application as the person who ran the day-to-day operations of the company, Legacy Consumer Directed Services. Had Martin listed her own name, the application would not have been approved as Martin did not meet the enrollment criteria. The requirement? No previous history of being convicted of a crime!  And Martin had a prior conviction.

Legacy Consumer Directed Services was approved to be a Medicare provider and from 2014 to 2022 Martin fraudulently billed the Missouri Medicaid program over $2.5 million for personal care services never provided. Defrauding Medicaid diverts valuable resources from beneficiaries. These funds diverted by Martin could have provided care to more than 200 people allowing them to stay in their homes instead of nursing facilities.

Instead, these funds helped Martin take family vacations and these trips ended up being the proof that services weren’t provided. Martin and two of her children, listed as home health care providers for Legacy, were out of town on trips to Miami, Las Vegas, or Atlanta when Martin claimed they were providing personal care services for Medicaid clients.

Martin went on to apply for and receive a loan of almost $60,000 from the COVID-19 pandemic-era Paycheck Protection Program. She claimed to use the loan for the company’s payroll but since there wasn’t really a payroll for her bogus company, Martin used the funds for personal interests.

On September 27, 2022, Martin was sentenced to 4 years and nine months in prison and ordered to pay restitution for both the Medicaid and PPP loan funds.

Great job by the Department of Health and Human Services for investigating this double fraud case.

Today’s Fraud of the Day is based on an article “Bogus company stole $2.5 million from Medicaid and left town, Missouri prosecutors say” published by The Miami Herald on September 28, 2022

A bogus healthcare company in Missouri stole $2.5 million from Medicaid and almost $60,000 from a pandemic-era loan program, prosecutors said. A trio of women – Barbara Martin, 63, of St. Charles, Missouri, her sister, Margo Taylor, 66, of St. Louis and her daughter, Zamika Walls, 38, of Atlanta are accused in the scheme.

In 2013, Martin enrolled the company in the Missouri Medicaid program, according to the U.S. Attorney’s Office for the Eastern District of Missouri. The company said it provided personal care services to Missouri homes, the indictment filed on June 2, 2021, said.

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