Whistleblower Tip Leads to Medicaid Fraud Conviction

A whistleblower tip lead to the successful Medicaid fraud prosecution of the owner of a Minnesota home care business. Mankato area resident Rebecca Swanson pleaded guilty to six counts of felony theft. The state’s Medicaid Fraud Control Unit claims that Swanson defrauded Minnesota’s Medicaid program by $417,000.

Whistleblower Tip Leads to Medicaid Fraud Conviction

According to prosecutors, Swanson ran a home healthcare company called Mybeck. Her company dispatched personal care assistants to client homes. In many cases the patients receiving the service were Medicaid recipients.

Authorities say that Swanson committed several Medicaid violations including the failure to conduct background checks on care assistants before dispatching them to patients’ home. In Minnesota, background checks are mandatory.

She was also accused of submitting time sheets for reimbursement even though she knew her company was using unqualified caregivers.

Home Health Care Businesses Frequently Engaged in Medicaid Fraud

Home care businesses have long been plagued by Medicaid fraud. It’s hard for a legitimate home healthcare agency to make it in some areas of the country because so many others are committing fraud. By stealing from the government, these companies can lower their prices and put honest providers out of business.

In addition to referring fraud cases for criminal prosecution, the state’s Department of Human Services also has the right to bar certain providers from participation in the Medicaid program. After being charged, regulators barred Mybeck from further participation in the program.

Home care and personal assistant providers represent the bulk of Minnesota’s barred providers. A review of Minnesota’s current list of “excluded providers” reveals that 76 out of 100 are home healthcare or personal care assistant vendors! State and federal law allow authorities to bar dishonest companies from participating in taxpayer funded healthcare programs such as Medicare and Medicaid.

Minnesota Pays Awards for Medicaid Fraud Tips

Minnesota is one of 29 states that pays awards to whistleblowers with inside information about Medicaid fraud.  Under the Minnesota False Claims Act, successful Medicaid fraud whistleblowers can receive between 15% and 30% of whatever is collected from the wrongdoers. The U.S. Department of Justice also pays awards for information on both Medicaid and Medicare fraud. Those awards are available in all 50 states.

Medicaid fraud hurts taxpayers everywhere. When unqualified caregivers provide services, chances are high that patients also suffer.

Healthcare workers with inside information about fraud are urged to come forward and report the fraud.

How to Claim a Medicaid Fraud Whistleblower Award

There are two ways of reporting Medicaid fraud in Minnesota. Both methods are quite simple but only one offers large cash awards.

The state’s Medicaid Fraud Control Unit, a part of the Department of Human Services, will accept tips by phone or email. Complaints can be made anonymously but no awards are available if you report directly to the agency.

To obtain an award, one must hire a lawyer and file a complaint in state or federal court. Don’t worry, the lawyers that handle these cases generally don’t require any money up front and only get paid if they are successful getting you an award. The Coalition can match you up with a qualified lawyer and at no charge.

To take the first step, call our operators at 888.742.7248. They will have a lawyer call you back with one business day. No cost. No obligation.


Medicaid Fraud Hotline: 888.742.7248 or Report Online