CARSON CITY – Marcia Giller, 76, of Reno, has been sentenced to prison for two felony offenses of submitting false Medicaid claims, the Attorney General’s office announced this week.
Washoe County District Judge Steven Kosach sentenced Giller on Tuesday to 18 to 48 months imprisonment for each count, to be served consecutively, and additionally ordered Giller to pay $226,000 in restitution, penalties and costs.
“In addition to jeopardizing the provision of health care to people in need, medical providers who submit fraudulent claims victimize every taxpayer who funds this beneficial and necessary program,” said Attorney General Catherine Cortez Masto. “The Medicaid system must be protected, and those who commit Medicaid fraud will be punished.”
Attorney General Catherine Cortez Masto.
In December 2009, Nevada Medicaid provided information to the Attorney General’s Medicaid Fraud Control Unit (MFCU) that AME Home Health Care (AME), a medical equipment company owned and operated by Giller, had submitted and been paid for Medicaid claims that were not supported by required documentation. Medicaid provides payment to medical equipment suppliers who furnish medical supplies that allow people to maintain hygiene, gain mobility and care for their own medical conditions.
Further investigation by the MFCU revealed that, in addition to the lack of supporting documentation, Giller repeatedly submitted claims for persons who did not actually receive supplies from AME. Giller nonetheless continued to submit fraudulent claims and receive payment over the course of several years. Although Giller submitted claims under supposed client names and numbers, those persons were unaware that their Medicaid information was being used in such a way.
The fraud occurred from January 2007 through May 2010.
Persons convicted of Medicaid fraud may also be administratively excluded from future Medicaid participation.
The case was investigated and prosecuted by the MFCU, which investigates and prosecutes financial fraud by those providing healthcare services or goods to Medicaid patients. The MFCU also investigates and prosecutes instances of elder abuse or neglect.