Nursing-home employee pleads guilty to Medicaid fraud

Published 12:00 am Saturday, June 14, 2008

COURTLAND—A former business manager for Courtland Healthcare Center pleaded guilty Thursday to six felony charges of travel-expense-related Medicaid fraud.

Cora Mae Lane, 45, of Courtland, was ordered to make restitution to the facility and will return to court in August for sentencing as part of a plea agreement accepted by Southampton Circuit Court Judge Carl Eason Jr.

From 2004 through 2006, while managing the business office at the nursing home, Lane submitted travel vouchers claiming that she traveled an average of 596 miles a week to and from various Virginia social services agencies as part of Medicaid eligibility reviews, a prosecutor told the court Thursday.

Those purported trips were in addition to her normal duties as business manager at the facility, according to Assistant Attorney General Eric Atkinson of the state’s Medicaid Fraud Control Unit.

Atkinson was prosecuting the case in Southampton’s court at the request of Commonwealth’s Attorney Eric Cooke, who wrote in an earlier court motion that he needed a special prosecutor for the Lane case “because of the special nature and complexity of these prosecutions.”

During a brief presentation of evidence at Thursday’s trial, Atkinson said it is uncommon for business office managers at health-care facilities to be heavily involved in Medicaid eligibility reviews.

Evidence submitted in a thick three-ring binder showed claims for travel reimbursement dating back to December 2003, starting small and growing to hundreds of miles purportedly driven each week, reimbursed at 36 cents per mile.

The government discovered the fraudulent activity during a June 2006 audit. After an investigation, it took action in February to reduce the company’s Medicaid reimbursements by more than $23,000, court records show.

Lane was indicted by a county grand jury in May on three felony counts of obtaining money under false pretenses and three felony counts of making false statements or representations in applications for payment. Each of the charges represents a year’s worth of illegal activity.

As part of her plea agreement, Lane consented to paying restitution to the company in the amount of $25,892.39.

Depending on the findings of a court-ordered pre-sentence report, she could face up to 20 years in prison and a $2,500 fine for each charge of obtaining money under false pretenses. Each of the charges of making false statements carries a potential of up to 20 years in prison and a $25,000 fine.