Twelve people, several of whom are from Southern Illinois, are facing charges in an alleged Medicaid Home Services Program fraud.
The people were charged in eight indictments Thursday by a federal grand jury in East St. Louis. They are charged with making false statements related to Health Care Matters, according to U.S. Attorney Stephen Wigginton.
The charges have a maximum penalty of 10 years in prison.
“Today’s indictments send a strong message to those who seek to defraud the Medicaid program in Illinois,” said Gerald T. Roy, special agent in charge, U.S. Department of Health and Human Services, Office of Inspector General.
A Medicaid waiver program, the Home Services Program aims to prevent unneeded institutionalization of people who could instead be cared for at home, at a lesser cost to the state. Such waiver programs are set up by states with federal approval, and use state and federal Medicaid funds to pay for services that would not typically be covered by Medicaid.
The indictments allege the 12 charged individuals received funds through the Home Services Program to which they were not entitled. According to Wigginton, several investigations discovered services being billed but not performed, because a personal assistant was in jail or out of town.
Other investigations allegedly showed a beneficiary was living in a hospital or nursing home, or was out of town, when the services were said to have been performed at the beneficiary’s home. Among the other accusations is that some personal assistants and beneficiaries took Medicaid payments for services that never took place, and then split the paychecks.
As an example, one beneficiary is accused of getting out of jail on a one-day furlough to meet with his case worker at home, so he could keep getting benefits under the Home Services Program. Medicaid then allegedly paid for personal assistant services for that person, although he was back in jail.
The 12 people indicted are:
• Earlene J. Lyns, 47, of Cairo;
• Martina S. Terbrak, 37, of Carbondale;
• Keith W. Foreman, 56, of Metropolis;
• Sheila F. McDonald, 53, of Metropolis;
• Barbara J. Adams, 69, of Patoka;
• Debra R. Squire, 50, of Patoka;
Generista Williams, 66, of Centralia;
• Earlean Williams, 49, of Centralia;
• Tontalan Johnson, 32, of Mounds;
• Vickie D. Deal, 42, of Madison;
• Lillie Vaughn, 54, of East St. Louis;
• Linda A. Davis, 55, of Cahokia.
The case was investigated by U.S. Department of Health and Human Services, Office of Inspector General, Illinois State Police and Medicaid Fraud Control Bureau in Du Quoin and Collinsville.