Crime

10 from region, including ESL teacher, charged with Medicaid fraud

Federal authorities announced Thursday the arrest of 10 Southern Illinois residents as part of operation “Home Alone IV,” a health care fraud take-down that investigators are calling the largest such operation in U.S. history.

Eight of those 10 are from the metro-east, and one is an East St. Louis teacher who stated on an aid application that he needed someone to drive him to work.

Also charged were an additional two individuals who had not yet been arrested as of Thursday afternoon.

According to an announcement from Southern Illinois U.S. Attorney Stephen Wigginton, the investigation centered on individuals who billed the government for health care services that were either never completed or that were not medically necessary. Eleven of the 12 people facing charges acted as personal assistants administering care and one was a recipient of care.

Those charged from the metro-east include:

▪  Kiara S. Hopkins, 24, Belleville

▪  LaTasha Stevenson, 37, Belleville

▪  Kevin L. Boyd, 58, East St. Louis

▪  Shirley A. Hair, 48, East St. Louis

▪  Alfreda E. Perkins, 53, East St. Louis

▪  Ann Marie Sheppard, 54, O’Fallon

▪  Lisa Jorden, 50, Cottage Hills

▪  Shelia Vickery, 40, Alton

Other Southern Illinois residents charged include:

▪  Terry L. Waeltermen, 30, Pochahontas

▪  Jessica A. Teets, 27, Mulberry Grove

Court documents show Boyd was a substitute teacher in East St. Louis District 189 from 2010 to 2014. Starting in September 2014, Boyd was employed full-time with the district. His indictment states that the only income he filed with the Internal Revenue Service came in the form of Social Security disability benefits.

It also stated that Boyd falsely claimed he was unable to drive to work even though he was able, and also stated that he received services from a personal assistant. He was not eligible for the services under federal welfare law because he was employed, according to the indictment.

Wigginton said Boyd’s elderly mother was listed as his personal assistant.

Authorities said Boyd was driving himself to school, although he was using his mother’s car. The indictment for Boyd doesn’t explain what happened to the money provided by the government for the services he was supposed to receive.

Hopkins and Hair were paid to perform services as personal assistants, but submitted fraudulent time sheets, according to the indictments.

Nationwide, the investigation resulted in charges against 243 people. The allegedly fraudulent billings total roughly $712 million, authorities said.

Wigginton said his office will continue to prosecute people who defraud the Medicaid system.

“People who cheat this system rob from from a very worthy program and steal directly from our fellow citizens,” he said.

Gerald Roy, special agent in charge with the U.S. Department of Health and Human Services Office of the Inspector General, said fraudulent billing for personal assistant services while the customer is in a nursing home or hospital is “especially galling.”

“The whole purpose of the program is to save federal and state money by providing assistance to recipients so that they don’t need to go to a hospital or nursing home,” Roy said. “I’ve been doing this for 17 years. I get angry every single time someone commits fraud and abuse. These people are our mothers, fathers brothers and sisters.”

Wigginton said the investigations have uncovered people who are “money-takers” rather than care-givers.

He gave some examples:

▪  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 the friend had been unable to reach the recipient by phone for many days. The daughter of the customer was her personal assistant and submitted claims for services.

▪  A personal assistant submitted false claims for services purportedly rendered in Illinois while the personal assistant was actually in Costa Rica.

▪  A personal assistant submitted false claims while the recipient was in jail

▪  A personal assistant submitted claims for services at the same time she was working as a personal assistant for a social services agency in East St. Louis.

▪  Several personal assistants submitted claims while their customers were in the hospital and nursing homes.

Wigginton said his office has received some of its best tips from neighbors and friends. He wants anyone who knows of someone committing fraud or abuse to call the U.S. Attorney's office at 628-3700.

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