The West Virginia Department of Health and Human Resources’ (DHHR) Medicaid Fraud Control Unit led the investigation of Patricia Lancaster, 64, who was convicted on June 18, 2018 of a felony charge of presenting false claims under medical programs. The charges were filed in Brooke County Circuit Court.
DHHR’s Medicaid Fraud Control Unit received a referral alleging that from October 1, 2006 through October 1, 2011, Lancaster falsely completed and submitted time sheets to Healthways, Inc. for payment of respite and adult companion services. Lancaster concealed the fact that she resided in the same home with the recipient which made her ineligible to provide respite services and falsely submitted times sheets of another person who was not providing services at the time. After a full investigation by DHHR’s Medicaid Fraud Control Unit, charges were filed, and an indictment was handed down on March 5, 2018.
As part of the plea agreement, Lancaster will serve a period of five years on supervised probation and is ordered to make restitution to DHHR in the amount of $181,484.
The Medicaid Fraud Control Unit, through DHHR’s Office of Inspector General, investigates and prosecutes or refers for prosecution allegations of health care fraud committed against the Medicaid program and allegations of the criminal abuse, neglect or financial exploitation of patients in Medicaid-funded facilities and residents in board and care facilities. Additionally, the Medicaid Fraud Control Unit is responsible for investigating fraud in the administration of the Medicaid program. Its mission is to protect West Virginia’s vulnerable citizens and the integrity of its health care programs.
To report Medicaid provider fraud or patient abuse, neglect or financial exploitation, call 304-558-1858 or 888-FRAUD-WV.