Healthcare fraud is prevalent within state Medicaid programs due to the massive amounts of money flowing through the system. In Louisiana, the Estate of Yolanda Burnom and her former company, Community Healthcare Solutions, LLC, recently agreed to pay $4.6 million to settle a False Claims Act lawsuit.
The allegations included providing incentives to Medicaid beneficiaries in exchange for allowing use of their coverage to bill for services that were never rendered. The Medicaid program is particularly vulnerable to this type of fraud because fraudulent providers prey on individuals who may need extra money simply to pay bills. Providers can offer incentives in many forms in exchange for the beneficiary saying nothing about not actually receiving care.
The criminal prosecution of Yolanda Burnom ended upon her death, but the Louisiana Attorney General and others recovered civilly some of the damages incurred by the state’s Medicaid program.
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