Mother-Daughter Defrauds Medicaid $100k+
Release Date
Sep 20, 2022
Contact
Kylie Mason
Phone
850-245-0150
TALLAHASSEE, Fla.—Attorney General Ashley Moody’s Medicaid Fraud Control Unit and the Miami-Dade Police Department today arrested Andrea Lozada Granados and Virna Granados for defrauding the Medicaid Program out of more than $100,000. The mother-daughter duo allegedly billed Medicaid for psycho-social rehabilitation services never rendered for six recipients.
Attorney General Ashley Moody said, “I’m glad we were able to stop this Medicaid fraud scheme ripping off the taxpayers of Florida. Now this mother-daughter duo will have to answer for this six-figure criminal scheme to defraud a taxpayer-funded program.”
According to the investigation, the duo’s scheme involved billing Medicaid for PSR services supposedly provided by Virna for individuals residing in an assisted living facility. During an interview, the Medicaid recipients stated that the defendants did not provide PSR services, and in fact, the recipients did not even reside at the assisted living facility claimed by the Granadoses.
For more than a year, Andrea and Virna allegedly used the personal information of these unwitting Medicaid recipients to create fictitious progress notes and attendance sheets, in addition to falsifying other personal information, to fraudulently cause Medicaid to pay more than $106,000 for PSR services never provided. Additionally, Andrea paid kickbacks to another employee in order to fraudulently bill for a Medicaid recipient who also never received PSR services.
Andrea and Virna are each charged with one count of Medicaid fraud, a first-degree felony, and one count of grand theft, also a first-degree felony. Additionally, Andrea is charged with a second count of Medicaid fraud, a second-degree felony.
Both Andrea and Virna face up to 30 years in prison and $30,000 in fines, if convicted.
Attorney General Moody's Office of Statewide Prosecution will prosecute this case.
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The Florida Attorney General’s Medicaid Fraud Control Unit investigates and prosecutes providers that intentionally defraud the state’s Medicaid program through fraudulent billing practices. Medicaid fraud essentially steals from Florida’s taxpayers. Additionally, the MFCU investigates allegations of patient abuse, neglect, and exploitation in facilities receiving payments under the Medicaid program. From January 2019 to present, Attorney General Moody's MFCU has obtained more than $138 million in settlements and judgments.
The Florida Medicaid Fraud Control Unit is funded through a grant totaling $27,734,297 for Federal Fiscal Year 2023, from the U.S. Department of Health and Human Services, Office of Inspector General. The Federal Share of these funds is 75% totaling $20,800,724. The State Matching Share of these funds is 25% totaling $6,933,573 and is funded by Florida.
The Florida Attorney General’s Medicaid Fraud Control Unit investigates and prosecutes providers that intentionally defraud the state’s Medicaid program through fraudulent billing practices. Medicaid fraud essentially steals from Florida’s taxpayers. Additionally, the MFCU investigates allegations of patient abuse, neglect, and exploitation in facilities receiving payments under the Medicaid program. From January 2019 to present, Attorney General Moody's MFCU has obtained more than $138 million in settlements and judgments.
The Florida Medicaid Fraud Control Unit is funded through a grant totaling $27,734,297 for Federal Fiscal Year 2023, from the U.S. Department of Health and Human Services, Office of Inspector General. The Federal Share of these funds is 75% totaling $20,800,724. The State Matching Share of these funds is 25% totaling $6,933,573 and is funded by Florida.