200,000 Alaskans<\/a> receive access to healthcare through Medicaid. <\/p>\nThe business accused of the largest dollar amount of Medicaid fraud is Graystone Assisted Living Home LLC, a small group home in the Muldoon neighborhood. State officials say the business submitted more than $1.1 million in Medicaid claims between 2022 and 2025 that lacked sufficient supporting documentation. <\/p>\n
Someone at the home who answered the phone called the charges unproven allegations but did not want to comment further. <\/p>\n
The state also filed charges against a married couple, Molly and Kyle Bates, who own several businesses in the Anchorage area, accusing them of nearly $619,000 in medical assistance fraud. This investigation involved an FBI agent. <\/p>\n
The three businesses listed in charges are Heritage Assisted Living Home LLC, Heritage Home LLC and Alaska Life Group Homes LLC. <\/p>\n
The couple wrote checks to an employee who described herself as a case manager for more than $1.7 million \u201cfor items such as \u2018BMW,\u2019 clothes, shopping, food, \u2018x-mas\u2019, and groceries,\u201d according to a criminal complaint filed in the case. The complaint also describes the business records reviewed during the investigation as chaotic.<\/p>\n
The couple could not be reached for comment. <\/p>\n
A Soldotna dental practice is also part of the state\u2019s Medicaid case. Dentist Joseph J. Mirci and Peninsula Family Dental Center LLC were charged with scheme to defraud, first-degree theft and 19 counts of medical assistance fraud. <\/p>\n
State fraud unit officials say the dentist and practice submitted nearly $84,000 in fraudulent claims for dental services that were not provided or medically necessary, were unsupported by patient records, failed to meet Medicaid requirements, or were billed at a higher level than performed.<\/p>\n
An initial charging document in the criminal case describes issues that surfaced during the investigation, including a child patient\u2019s adverse reaction to nitrous oxide and numerous reports of dental work that patients didn\u2019t need or approve. The document includes information from several former employees who say Mirci intentionally changed billing statements to receive more Medicaid funds. <\/p>\n
Contacted for comment on the allegations against the practice last month, an employee asked a reporter for a copy of the state\u2019s press release. They did not respond to subsequent requests for comment. <\/p>\n
In a fourth case, a 36-year-old Kenai man is facing charges of medical assistance fraud, second-degree theft and falsifying business records. He is accused of billing Medicaid more than $4,400 for personal care services that were never provided. The person in his care, a family member, was later admitted to the hospital in a condition described as \u201csevere neglect,\u201d according to an initial charging document filed in the criminal case. <\/p>\n
In another case, two members of an Anchorage family are accused of making more than $13,700 in fraudulent Medicaid claims and facing charges of scheme to defraud, second-degree theft, falsifying business records and two counts of medical assistance fraud. They are accused of providing respite and personal care services for a relative that didn\u2019t occur, according to a charging document in the case. <\/p>\n
Asked if it\u2019s possible the cases may resolve once the defendants provide more paperwork, fraud unit director Heather Nobrega said that\u2019s unlikely. <\/p>\n
\u201cThese investigations are lengthy and the defendants have been given ample time to produce the records,\u201d Nobrega said in an email. <\/p>\n
Medicaid rules require care providers to finish records at the same time as the service offered, but if that\u2019s not possible, they must be completed within two weeks, she said. <\/p>\n
Every state has a Medicaid Fraud Control Unit, funded by the federal government and staffed by attorneys and investigators, according to Shirley Sakaye, spokesperson for the Alaska Department of Health. <\/p>\n
Along with the fraud unit, the department works with agencies including the U.S. Department of Justice and the Office of Inspector General, she said. <\/p>\n","protected":false},"excerpt":{"rendered":"Fraud investigators at the Alaska Department of Law have charged 15 defendants with approximately $1.83 million in what…\n","protected":false},"author":2,"featured_media":751551,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[59],"tags":[230,26096,322330,13468,97,252,253,10791,5033],"class_list":["post-751550","post","type-post","status-publish","format-standard","has-post-thumbnail","category-health-care","tag-architecture","tag-building","tag-buildinghhsheadquartersarchitecturestyle","tag-headquarters","tag-health","tag-health-care","tag-healthcare","tag-hhs","tag-style"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts\/751550","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/comments?post=751550"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts\/751550\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/media\/751551"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/media?parent=751550"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/categories?post=751550"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/tags?post=751550"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}