September 27, 2023

🔒 Operator of prenatal care enterprise charged after illegally receiving $2.3 million in funds from Wisconsin Medicaid

A Milwaukee lady is dealing with 10 expenses of well being care fraud, in addition to 10 different various fraud expenses, after she allegedly despatched in false funds to the Wisconsin Medicaid program in an effort to obtain cash for providers she didn’t present to her shoppers.

Markita Barnes was the proprietor and operator of Right here For You Prenatal Care Coordination Providers LLC (HFY). The corporate presupposed to be a prenatal care coordination and childcare coordination firm, which billed Wisconsin Medicaid for providers it claimed to supply pregnant girls and moms in Milwaukee. The corporate beforehand operated at 3775 N. Richards St.

Barnes allegedly submitted payments totaling over $2.5 million, which contained false statements, to Wisconsin Medicaid. After submitting these payments, Wisconsin Medicaid paid Barnes over $2.3 million.

Medicaid is a authorities program that gives medical health insurance to low earnings people.

Barnes used these funds to make a number of private purchases, together with a Mercedes Benz price $74,000, diamond-crusted pendants and earrings, a Rolex watch, and an Audi truck, based on the indictment.

Starting in October 2020 by way of a minimum of December 2021, Barnes would promote her firm on Fb and encourage girls to enroll by providing free child provides. She would additionally supply cash to people, generally as much as $100, to enroll in providers at HFY — what’s often called a well being care kickback.

It’s unlawful for anybody to supply, pay, solicit or obtain cash in alternate for referring Medicare and Medicaid beneficiaries to suppliers that take part in this system, or to rearrange for sure providers which may be paid for partially or complete by Medicare of Medicaid.

As part of her scheme, Barnes allegedly incentivized her staff to inflate their billing to Wisconsin Medicaid by tying their earnings to the quantity they billed. Barnes instructed her staff to falsify billing submissions that knowingly misstated the length, frequency, date, and frequency of providers supplied, based on the indictment.

For instance, the indictment says Barnes claimed she spent two hours serving to a buyer fill out W-2 tax kinds and apply for meals stamps, however these providers have been by no means supplied. Barnes additionally allegedly lied about serving to different prospects join parenting lessons and organising appointments with the Ladies, Infants and Kids Program.

“Barnes willfully tried to stop, hinder, mislead, and delay the communication of knowledge and information regarding the scheme, a violation of federal well being care offense, by instructing her care coordinators to ‘remind’ their shoppers that they supplied assets and to inform investigators that the knowledge on the progress notes used to assist billing Medicaid was true,” based on the indictment.

Upon conviction, Barnes can be pressured to forfeit something she bought with the cash that got here from Medicaid and pay again the full quantity of funding she illegally obtained.