Lawrence County, Ky. medical practice, employees charged with Medicaid fraudStaff Writer | August 16, 2016
Kentucky Attorney General Andy Beshear and his Office of Medicaid Fraud and Abuse announced the indictment of a Lawrence County Medical Practice and the arrest of three providers of the practice on charges related to Medicaid fraud and forgery of prescriptions.
Kentucky Tri-State Family Medical Center faces up to $20,000 in fines
Baldera faces up to 20 years for four Class D felonies including two counts of Medicaid Fraud; one count of forgery of a prescription; and two counts related to unlawful prescribing of controlled substances.
Kevin Gauze faces up to 20 years for five Class D felonies including two counts of Medicaid Fraud; one count of forgery of a prescription; two counts related to unlawful prescribing of controlled substances; and one count related to unauthorized procurement of controlled substances.
Janice Gauze faces up to five years for one Class D felony related to unauthorized procurement of controlled substances.
In addition, Tri-State Family Medical Center faces up to $20,000 in fines for two counts of Medicaid fraud and one count of forgery of a prescription.
It is alleged that between 2010 and 2013, Kevin Gauze and Alfred Baldera fraudulently billed Medicaid for office visits and drug testing where the patients were not present. This resulted in a substantial loss to the Medicaid program.
It is also alleged that during 2016, Kevin Gauze and Baldera fraudulently billed Medicaid for services utilizing Baldera as a performing provider when Baldera was not present to perform the services.
Additionally, it is alleged that Baldera and Kevin Gauze engaged in forging prescription for controlled substances when Gauze forged Baldera’s name to Medicaid and non-Medicaid patients’ prescriptions when Baldera did not provide the services.
Additionally, it is alleged that Kevin Gauze forged Baldera’s signature on prescriptions for controlled substances for himself.
Also, it is alleged that Janice Gauze presented prescriptions for controlled substances which were not authorized by law.
Their arraignment has not been scheduled by the Lawrence Circuit Court. ■