Medicaid Fraud Results in Jail Sentence

FOR IMMEDIATE RELEASE : Tuesday, December 13, 2011
CONTACT: Sara Rabern, (605) 773-3215

PIERRE, S.D. – Attorney General Marty Jackley announced today that Larry Lee Jones, 63, Yankton, South Dakota, was sentenced to serve 180 days in the State Penitentiary for committing Medicaid fraud.

Jones pled guilty in November to one count of Making False Claims to Medicaid, a class 5 Felony, pursuant to a plea agreement reached with the State. Jones admitted that he submitted false claims to Medicaid while operating the Yankton Chiropractic Center. The South Dakota Board of Chiropractic Examiners revoked Jones’s license last week.

A patient notified law enforcement of suspicions that Jones was submitting fraudulent claims to Medicaid and Medicare. The subsequent investigation revealed that Jones was submitting claims to Medicaid and Medicare for patient visits that did not occur. The patient has requested to remain anonymous.

“We encourage patients to contact us if they have suspicions about Medicaid providers,” Jackley said. “The information from this patient saved taxpayers thousands of dollars, and we commend this patient for doing the right thing.”

Circuit Court Judge Glen W. Eng suspended the imposition of sentence on the condition that Jones be placed on supervised probation for 5 years, serve 400 hours of community service, and pay restitution of $2,633.92 to the State. Jones must also pay a fine of $5,000, and court costs of $104.

The case was investigated and prosecuted by the South Dakota Medicaid Fraud Control Unit, with assistance from the Division of Criminal Investigation, the Department of Health and Human Services Office of Inspector General, and the Department of Social Services.

3 Responses to “Medicaid Fraud Results in Jail Sentence”

  1. I am always heartened to see scammers exposed and busted.  Those of us that try to help patients and seek just compensation detest those that try to rip-off the system–they are taking from deserving patients, deserving practitioners and the American taxpayer.

    It troubles me, however, that efforts to reveal and prosecute fraud are always directed at the providers when, in fact, much of the fraud occurs on the other side of the equation, the recipients: unnecessary ER visits, demands for drugs and procedures that are not indicated, disability fraud, SSI fraud, drug-seeking, etc.  These account for billions each year but politicians are reluctant to point the finger at the real problem.

    I applaud efforts to bust the doctors, labs, physical therapy providers, pharmacies and others that attempt to rip-off government programs, but I wish the same diligence were applied to the recipients that waste billions on frivolous demands and over-use of the medical system.

  2. Amen, Dr. Theo! Sadly our political system has the “political guts” to hammer the big bad doctors and healthy care industry people (and rightly so, if they’ve broken the law), but little to no will to deal with Joe Public lawbreaker.

    The Bible says not to favor a poor man in his lawsuit, and I believe the principle applies not only to economic status but also professional status and other demographics. In other words, apply the law uniformly without looking the other way when “favored classes” violate.

  3. Thank you for your efforts, Lora.