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Missouri Woman Gets Almost 5-Year Prison Term For $2.5 Million Medicaid Fraud Scam

Earlier this week, 63 year-old Barbara Martin was sentenced in a St. Louis, Missouri courtroom. A total of four years and nine months in prison was the sentence she received for her role in a $2.5 million fraud scam. It involved Missouri’s Medicaid program and a nearly $60,000 fraudulent Paycheck Protection Program loan. Martin has been ordered to repay $2,566,989 to Missouri’s Medicaid program and $58,295 to the U.S. Small Business Administration.

Martin pleaded guilty on June 28.

As reported by the Eastern District of Missouri branch of the United States Department of Justice, Martin was charged with conspiracy to commit health care fraud and bank fraud conspiracy. In her guilty plea, she admitted being the administrator for Legacy Consumer Directed Services. It was a business that fraudulently enrolled in the Missouri Medicaid program to provide personal care services in 2013.

“Martin falsely listed the name of her daughter, Zamika Walls, on the application to conceal her own role and the role of her sister, Margo Taylor, as the people who ran the day-to-day operations of the company,” reports the DoJ, “Walls was listed as the director of the company but was not involved in its operation. Had Martin listed her name or Taylor’s, the application would not have been approved as they did not meet the enrollment criteria.”

Martin lied on her application.

She falsely checked “no” in response to the question asking whether the applying provider had ever been convicted of a crime. Subsequent to the falsely-filled application, Legacy billed the Missouri Medicaid program a total of over $2.5 million. The billings took place between May 2014 and September 2020.

Some of that money was for care that was never provided. Martin, Walls and another child of Martin’s who was not named in court documents were out of town during the times in question. They were on trips to Miami, Las Vegas or Atlanta when Martin claimed they were providing personal care services for Medicaid clients. Not to mention, Walls lived in Atlanta.

Martin actively subverted controls designed to prevent fraud.

Arvids Petersons is the director of the Medicaid Fraud Control Unit of the Missouri Attorney General’s Office. In court, he said that the $2.5 million that Martin billed to Medicaid would provide personal care services that could keep more than 200 people in their homes instead of skilled nursing facilities.

Martin and Walls also conspired to submit a fraudulent loan application to the Paycheck Protection Program. The COVID-19 pandemic-era program was designed to help save small businesses and jobs on behalf of Legacy. As the DoJ reports, Martin lied when she claimed the loan would be used to pay salaries, mortgage or lease payments and utility bills.

“In support of the application, Martin submitted fake payroll data and eventually received a $58,295 loan,” reads the report, “After Legacy ceased operations, Martin submitted a fraudulent application seeking forgiveness of the loan, falsely claiming the loan money had been used for authorized purposes.”

Walls has received a 15-month prison term and has been ordered to repay $127,491. She pleaded guilty on June 16 to the same charges as her mother. Taylor pleaded guilty on July 11 to two counts of health care fraud and is scheduled to be sentenced October 19.

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