AG Sam Olens announces Medicare fraud conviction

Via press release:

On February 9, 2012, after a three day trial, a DeKalb County Jury found Janine Wright, a speech therapist from Stone Mountain, guilty of defrauding the Georgia Medicaid program.

The evidence showed that from June of 2008 through January of 2010, Wright submitted over 900 false Medicaid claims under the Medicaid numbers of fifteen children, totaling $59,570.25, for speech therapy services she never provided.

Wright submitted claims under the Medicaid numbers of children for dates prior to the first time she actually saw them as a patient. She submitted claims under the Medicaid numbers of children who had stopped coming to her for speech therapy, including one child whom she had discharged because she was unable to meet the child’s special needs.  She submitted claims under the Medicaid numbers of children who never came to her for speech therapy. And for children who actually came to her for speech therapy, she submitted Medicaid claims for many more sessions of speech therapy than she actually delivered.

After the jury returned its verdict, DeKalb County Superior Court Judge Daniel M. Coursey sentenced Wright to four years in prison, to be followed by six years of probation. He further sentenced Wright to pay a fine of $5,000.00 to DeKalb County, and full restitution of $59,570.25 to the Georgia Medicaid program.

The fraudulent billing pattern was first discovered by Investigator Kevin Banks and Nurse Investigator Kay McCourt with the Office of Inspector General of the Georgia Department of Community Health.  The case was referred by them to the Georgia Medicaid Fraud Control Unit, a Unit of the Georgia Attorney General’s Office.


    • drjay says:

      i am aware of one instance where a paperclip was alledgedly used for a dental procedure that seemed ok. college student had broken the lingual bar on her lower teeth (a retainer bonded to the inside of the bottom front teeth after getting braces to keep the teeth from shifting) she went to a local dentist in her college town that was on her parents insurance list. he was not an orthodontist, did not have any ortho wire, so he shaped a paperclip to fit into the space and bonded it in place until she could go home to see her orthodontist in her home town. i’m not saying i would do that, but i guess it worked in a pinch…of course i heard this at least 2nd hand from a dental asst. so it may be untrue in any event…

  1. saltycracker says:

    So what’s the ratio ?
    20,000 more just like that in 2012 alone and we can begin to put a dent in Georgia medicare fraud ?

  2. taylor says:

    Health reform is hard.

    There’s a difference in Medicare and Medicaid – a big one. Medicare is the federal program and everyone receives in at age 65. Medicaid is a federal-state program for the poor.

    • saltycracker says:

      Correct – over abbreviated gov’t health care programs – key word is (excessive) fraud.

      “Health reform is hard, it’s harder if the program is stupid.”
      John Wayne (?)


Comments are closed.