AG files Medicaid fraud charges against Mountain Grove woman

A licensed professional counselor in Mountain Grove has been charge with 11 felony counts of Medicaid fraud, one count of obstruction and one count of stealing by deceit, Missouri Attorney General Chris Koster said Wednesday.

Koster and Wright County Prosecuting Attorney Jason MacPherson filed the charges against Lorraine R. Kusior. She is charged with submitting false reimbursement claims to Medicaid for counseling services she did not perform and providing false patient records with the intent to defraud the state and MO HealthNet, according to a release from Koster's office.

Koster said in the release that a review of subpoenaed information by his office's Medicaid Fraud Control Unit found evidence of inflated Medicaid billing by Kusior - allegedly more than $12,000. She is charged with two Class D felonies, punishable by up to four years in prison for each violation, and 11 Class C felonies, punishable by up to seven years for each violation, plus penalties and restitution.

In a separate news release yesterday, Koster announced record Medicaid fraud collections in Missouri for 2009, resulting in the recovery of $81.6 million. That amount, obtained by the Medicaid Fraud Control Unit, is more than double the previous record of $33.6 million recovered in 2008.

During 2009, the unit obtained three state criminal convictions and helped the U.S. Attorney's Office obtain five federal criminal convictions. The unit settled 13 civil Medicaid fraud lawsuits and obtained summary judgment on one civil suit.

Koster noted in the release that two lawsuits against pharmaceutical companies contributed significantly to the record amount recovered. Warrick Pharmaceuticals paid a $31 million settlement, and in September, Pfizer paid Missouri $22 million as part of the largest nationwide Medicaid fraud settlement, the release said.

"This record-breaking year for collections is testimony to the importance of the Attorney General's Office staying focused on Medicaid fraud with the purpose of recovering money stolen from our health care system," Koster said in the release.

He noted that citizens also play a key role in fighting Medicaid fraud by reporting suspected fraud via the toll-free Medicaid Fraud Hotline, (800) 286-3932.