A Pocahontas man was charged last week in what federal authorities dubbed Operation Home Alone IV, a sweeping investigation of alleged abuse of the Medicaid system.
According to federal prosecutors, Terry L. Waeltermen, 30, Pocahontas was one of 12 people charged.
Other individuals charged and arrested were Kevin Landis Boyd, 58, of East St. Louis; Shirley A. Hair, 49, of East St. Louis; Kiara S. Hopkins, 24, of Belleville; Lisa Jorden, 50, of Cottage Hills; Shelia Vickery, 40, of Alton; Alfreda E. Perkins, 53, of East St. Louis; Ann Marie Sheppard, 54, of O’Fallon; LaTasha Stevenson, 37, of Belleville; and Jessica A. Teets, 27, of Mulberry Grove.
While indictments did not spell out specifics of the allegations against each defendant, prosecutors said charges were for with submitting bills for claimed personal assistant services that were purportedly medically necessary, but were not performed. Eleven of the 12 defendants were purported personal assistants and the other was a supposed recipient of the services.
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“I find billing for personal assistant services while the customer was in a nursing home or hospital to be especially galling.” said Gerald Roy, special agent in charge of the U.S. Department of Health and Human Services Office of Inspector General in Kansas City. “The whole purpose of the program is to save federal and state tax money by providing assistance to recipients so that they don’t need to go to a hospital or nursing home.”
The indictments are the fourth wave of charges targeting the abuse of a program in Illinois that provides personal assistants to Medicaid recipients to assist them with general household activities and personal care, federal authorities said. The program is intended for recipients under 60 years of age and is designed to reduce Medicaid expenditures by avoiding more expensive institutional care, including nursing home care.
“The home-care program provides vital services for many of our state’s most vulnerable residents,” said Illinois Attorney General Lisa Madigan. “These prosecutions are critical to ensure that the integrity of the program is maintained.”
The Southern District of Illinois was one of the 17 U.S. attorneys offices participating in the nationwide takedown. Several hundred federal agents took part in the arrests that began on Tuesday, June 16.
Operation Home Alone IV centered on both medical services that were never performed but billed to the government together with medical services that were performed but were medically unnecessary.
Two other defendants, who were yet to be named, have been charged, but not yet arrested, according to authorities.
Previous Operations Home Alone I through III had resulted in the indictment of 43 individual defendants. Of those, 42 were convicted (one died before sentencing) and given federal sentences ranging up to three years in federal prison.
“After three previous rounds of indictments, I am truly mystified how these defendants thought they could get away with defrauding Medicaid through bogus claims of personal assistant services,” said Steve Wigginton, U.S. attorney for the Southern District of Illinois. “I know that we can’t prosecute our way out of this problem; but the fact remains that I will continue to prosecute until there is no such widespread abuse of this program. People who cheat this system rob from a very worthy program and steal directly from our fellow citizens.”
Operation Home Alone IV Allegations
In indictments returned last week in the Southern District of Illinois, defendants are being charged with submitting bills for claimed personal assistant services that were purportedly medically necessary, but were not performed. Eleven of the 12 defendants were purported personal assistants and the other was a supposed recipient of the services.
Among the Operation Home Alone IV cases, are the following:
▪ A recipient was found in her home in an incoherent state and partially covered in dried excrement. She was discovered by a friend checking on her welfare after she had been unable to reach the recipient by phone for many days. The daughter of the customer was her Personal Assistant (PA) and submitted claims for services.
▪ A recipient, who purportedly was unable to drive a car to work, indeed did drive to work as an East St. Louis School teacher. He also failed to disclose to the Social Security Administration that he was substantially gainfully employed as a teacher.
▪ A PA submitted false claims for services purportedly rendered in Illinois while the PA was actually in Costa Rica.
▪ A PA submitted claims while the recipient was in jail.
▪ A PA submitted claims for services at the same time she was working as a PA for a social services agency in East St. Louis.
▪ Several PA’s submitted claims while their customers were in the hospitals and nursing homes.