October 16, 2013
Defendant Billed Medicaid for Items Not Provide
Carson City, NV – Nevada Attorney General Catherine Cortez Masto announced that Isidora DeGuzman, 53, of Las Vegas, was sentenced today for the gross misdemeanor offense of intentional failure to maintain adequate records for a fraud scheme involving submission of billing to Medicaid for different types or quantities of items than were actually delivered to Medicaid recipients.
“Any degree of Medicaid fraud damages the Medicaid system and robs it of the resources to provide services to people in actual need,” said Masto. “We will pursue and prosecute those who choose to profit by harming others and stealing taxpayer dollars.”
District Court Judge Kathleen Delaney adjudicated DeGuzman guilty and ordered payment of restitution and penalties of $6,822. DeGuzman also agreed to pay $20,000 in investigation and prosecution costs.
In January 2009, the Attorney General’s Medicaid Fraud Control Unit (MFCU) investigated a medical equipment company that had fraudulently billed Medicaid using patient information it had apparently stolen from Joy Mobility and Medical Supplies (Joy). Further analysis of the patient data and delivery receipts revealed that Joy, under the management of DeGuzman, was also engaged in its own Medicaid fraud scheme.
Joy was a medical equipment provider that supplied items such as incontinence supplies and mobility assistive devices. Medicaid provides payment for furnishing these items that allow people to care for their own medical conditions, gain mobility and maintain hygiene. Investigation by the MFCU revealed that Joy would deliver some items to its clients, who were Medicaid recipients, but Joy would then claim to Medicaid that it delivered a greater quantity of items or that it delivered different and more expensive items. Medicaid would unknowingly pay Joy based on the fraudulent information.
The case was handled by the MFCU, which investigates and prosecutes financial fraud by those providing health care services or goods to Medicaid patients. The case was prosecuted by Matthew Jensen, Senior Deputy Attorney General.
Persons convicted of Medicaid fraud may also be administratively excluded from future Medicaid participation.
The MFCU also investigates and prosecutes instances of elder abuse or neglect. Anyone wishing to report suspicions regarding any of these concerns may contact the Medicaid Fraud Control Unit in Carson City 775-684-1100 or in Las Vegas 702-486-3420. Medicaid fraud information can also be found on the Attorney General’s web site: http://ag.nv.gov/.