Sunshine Sentinel

TALLAHASSEE, Fla.—Attorney General Ashley Moody’s Medicaid Fraud Control Unit and the Jacksonville Sheriff’s Office today arrested a disabled care provider for Medicaid fraud. Melissa Wilson Clea is accused of failing to render services and falsifying documentation logs for two disabled Medicaid recipients. Clea fraudulently billed Medicaid for 77 claims totaling more than $11,000.

Attorney General Ashley Moody said, “Not only did this defendant fraudulently bill the Medicaid program and steal from Florida taxpayers for more than three years, she failed to provide health support services to disabled recipients and only contacted them once a year to acquire an annual report to ensure her scheme continued. I am proud of my Medicaid Fraud Control Unit for shutting down this greedy schemer.”

According to the investigation, Clea worked as a waiver support coordinator for Hands That Care, Inc. For more than three years, Clea billed for and received reimbursements for services purportedly rendered to two disabled Medicaid recipients in Clay and Duval counties. Clea submitted 77 claims totaling more than $11,400—the program denied seven of the claims and Clea received more than $10,400 deposited into a personal bank account.

Support coordination services include ongoing case management to ensure recipients access services needed to maintain health, safety and welfare. Coordinators are required to contact recipients regularly and have face-to-face visits. Coordinators are also required to maintain progress notes for all contacts, visits and assistance provided on behalf of the recipient. During the investigation, authorities contacted the caregivers of the disabled recipients, who stated Clea did not contact them except for once a year to sign a yearly support plan. Investigators also reviewed Clea’s files and found expired eligibility worksheets, required provider documentation missing and minimal case notes lacking specifics.

Clea faces one count of scheme to defraud, a third-degree felony. Attorney General Moody’s MFCU will prosecute the case through an agreement with the State Attorney’s Office for the Fourth Judicial Circuit.

Original source can be found here.