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Medicaid fraud comes in all shapes

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Local,Andy Brownfield

Medicaid fraud takes all forms.

As Shelly Martin, supervising attorney of Maryland's Medicaid Fraud Control Unit, says, "If there's a way to commit fraud someone's figured out, it's probably been reported to us in one way or another."

Two-thirds of fraud is reported through whistleblowers, who receive 15-25 percent of any settlements, Martin said.

Here's a look at some of the ways everyone from pharmaceutical companies to local dental aides have tried to rip off the system:

• Maryland received more than $10 million from Abbott Laboratories as part of a large suit involving 48 states and D.C. Abbott allegedly told doctors their seizure drug Depakote could be used to control agitation and aggression in elderly dementia patients, as well as treat schizophrenia -- all uses not approved by the FDA. Abbott allegedly paid kickbacks to doctors to encourage them to prescribe Depakote.

• Vontina Montez Hall, 38, of York, Pa., was banned from receiving Medicaid payments for five years after pleading guilty to billing Medicaid $112,000 for hundreds of psychotherapy sessions she never provided at two offices in the Baltimore area. She was given a five-year suspended sentence and five years probation and ordered to pay back the money she scammed.

• The state recouped nearly $160,000 in restitution and penalties from All About Your Health Care Services for breaking numerous Medicaid regulations. The firm provided home health aides to individuals, hospitals and nursing homes without providing required physician supervision. It also billed Medicaid for services that didn't meet the program's regulations. One of its nurses also lived with a patient, in violation of Medicaid rules. - Andy Brownfield

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