The Wisconsin Department of Justice has filed criminal charges in separate cases against two women – including one from Milwaukee – for allegedly defrauding Wisconsin’s Medicaid system.
Zambia Bell, 48, of Milwaukee, faces 10 counts of medical assistance fraud and one count of theft by fraud.
A second woman, Carolyn Franco, 45, of Pueblo, Colorado, is charged with three counts of medical assistance fraud and one count of theft by fraud.
The charges against Franco and Bell were filed in circuit court in Madison on June 18 and June 23, respectively, online court records show.
According to the criminal complaints, both women were hired as personal care workers for people they knew through Medicaid’s “Include, Respect, I Self-Direct” (IRIS) program. Both criminal complaints allege the women fraudulently filled out timecards for the IRIS program, stating they worked hours that they did not.
The criminal complaint against Bell alleges she submitted timecards that showed her working more than 24 hours in a single 24-hour period on 437 different occasions, resulting in excess payments to Bell from Wisconsin Medicaid of at least $43,081.
The complaint further alleges that, if Bell actually only worked 16 hours per day, then she fraudulently received $100,447 from Wisconsin Medicaid.
The criminal complaint against Franco alleges she submitted timecards on dates she was in a different state than the person she cared for and therefore could not provide care. The complaint alleges she defrauded Wisconsin Medicaid of at least $16,000.
“The Wisconsin Department of Justice works to protect the integrity of government programs,” Wisconsin Attorney General Josh Kaul said in a statement. “We remain committed to pursuing justice in cases involving the alleged defrauding of Wisconsin Medicaid.”
The two cases were referred to the Wisconsin Department of Justice by the Wisconsin Department of Health Services – Office of the Inspector General.
Bell is expected to make her initial court appearance Aug. 13 in Dane County. Franco’s initial appearance is scheduled for Sept. 3.
The investigation was led by the Wisconsin DOJ Medicaid Fraud Control and Elder Abuse Unit and Division of Criminal Investigation. Wisconsin DOJ is prosecuting the case.
Chris Ramirez covers courts for the Milwaukee Journal Sentinel. He can be reached at caramirez@gannett.com.
This article originally appeared on Milwaukee Journal Sentinel: Milwaukee woman charged with defrauding state’s Medicaid system
Reporting by Chris Ramirez, Milwaukee Journal Sentinel / Milwaukee Journal Sentinel
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By Chris Ramirez, Milwaukee Journal Sentinel | USA TODAY Network
