Another criminal charge in Medicaid fraud case | Arkansas Blog

Tuesday, October 9, 2018

Another criminal charge in Medicaid fraud case

Posted By on Tue, Oct 9, 2018 at 11:46 AM

A former billing clerk for an affiliate of Preferred Family Healthcare has been charged with a felony count of Medicaid fraud for making false statements that caused overpayments to Health Resources of Arkansas, a behavioral health agency in Batesville.

Vicki Chisam, 65, allegedly submitted false statements from January 2015 to November 9, 2015. The statements caused $589,000 in overpayments, according to a release from Attorney General Leslie Rutledge, whose Medicaid fraud unit investigated.

State charges had been filed earlier against Robin Raveendran of Little Rock, former director of program integrity and operations for PFH, and Helen Balding, director of billing. Chisam is accused of helping Raveendran, Balding and others. The state investigation is an offshoot of a wide-ranging federal investigation that has netted two former PFH lobbyists, an accountant for PFH, a clinical director for PFH and four legislators.

Several top officials of PFH were ousted as the criminal investigation unfolded, but they have not been charged with crimes. PFH recently filed a lawsuit against three former executives in Springfield, Mo., home to the multistate organization, over alleged embezzlement.

The affidavit for the latest arrest said current leaders of PFH cooperated in providing information that led to the charges. Chisam is accused is billing Medicaid for full amounts, rather than just 20 percent copayments. It said she first objected, but when Raveendran told her to bill full amounts, she manipulated the system until she found a way to do that. It also said she instructed others on how to manipulate the system.

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