Washington State

Office of the Attorney General

Attorney General

Bob Ferguson

FOR IMMEDIATE RELEASE:

AG’S office charges Spokane woman for defrauding Medicaid

Spokane--The Attorney General’s Medicaid Fraud Control Unit (MFCU) has charged a Spokane County woman with overbilling the Medicaid program that provides health care services funding for low-income citizens.

Ella M. Mertens was arraigned Wednesday in Spokane County Superior Court on six felony counts comprised of second degree theft, Medicaid False Statement and forgery.  Mertens was charged in connection to personal in-home care services she was contracted to provide to two Medicaid recipients and a privately-paid client.

The charges filed by Assistant Attorney General Lynn Mounsey Longmeier are based on an investigation which revealed that Mertens billed Medicaid from June 2005 through December 2006 during time periods when she provided little or no care.

Selected time sheets submitted by Mertens to her employers were reviewed by a forensic document examiner who believes that many of the client signatures were either traced or “free hand forged”. MFCU Investigator Larry Carlier’s interviews of those clients confirmed that they did not sign many of the questioned time sheets.  Mertens’ timesheets were submitted to her former employer, Home Care of Washington and her most recent employer, Addus Healthcare. Both companies have offices in Spokane County. As a result of submitting apparently manipulated timesheets, Mertens is charged with having been overpaid by Medicaid.

Medicaid, jointly funded by the state and federal government, provides health insurance for qualifying low-income and needy people.  Medicaid eligible recipients can include children, the elderly, and persons with a disability.

Mertens pled not guilty to all charges. Trial is set for April 6, 2009, in Spokane County Superior Court.

The Attorney General's Medicaid Fraud Control Unit is responsible for the investigation and prosecution of healthcare provider fraud committed against the state’s Medicaid program.  In addition, the unit coordinates the investigation and prosecution of abuse and neglect involving vulnerable adults residing in Medicaid funded residential facilities with local law enforcement authorities through a statewide contact network.

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Contacts:

Janelle Guthrie, AGO Communications Director, (360) 586-0725

 

 

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