Kenosha Business Owner Charged with Medicaid Fraud

Nov 14 2014
Kenosha Business Owner Charged with Medicaid Fraud

 

MADISON — Attorney General J.B. Van Hollen announced today that a Kenosha woman has been charged with seven counts of medical assistance fraud, two counts of forgery and one count of racketeering activity.  A preliminary hearing has been scheduled for December 16, 2014, at 9:30 am. 

 

According to the Department of Justice’s criminal complaint, Carleen D. Larson, R.N., Kenosha, was the owner of The Caring Heart, a home health personal care agency that was a certified Wisconsin Medicaid provider.  Larson was responsible for all agency business operations, including prior authorization requests and billing.  Wisconsin Medicaid is a program jointly funded by the state and federal governments that pays for health-related services to low income and medically needy persons.

 

An investigation showed that between July 2005 and July 2014, The Caring Heart billed for cares when services had not been provided.  Included with the false billings were prior authorization requests for which Larson allegedly forged doctors’ signatures.  The Caring Heart billed approximately 94,987 hours, receiving $1,522,307.56 in payments due to these false billings.

 

The complaint, available here, was filed in Kenosha County Circuit Court on November 13 at the time of the initial appearance.  A criminal complaint is a document accusing a person of a violation of criminal law.  A defendant is presumed innocent unless and until proven guilty.  The prosecution must prove its allegations at trial.

 

 The case was investigated and is being prosecuted by the Wisconsin Department of Justice Medicaid Fraud Control and Elder Abuse Unit.