Idaho Man Sentenced for Medicaid Provider Fraud
(KLIX) – An Idaho man has been sentenced to five years in prison for Medicaid provider fraud, according to Attorney General Lawrence Wasden.
Elwood Conica, 46, of St. Anthony was sentenced Monday in Seventh District Court, explained information from Wasden’s office. He pleaded guilty in January, but the fraud was initially discovered in July 2016 by the Idaho Department of Health and Welfare’s Medicaid Program Integrity Unit.
Besides his prison term, Judge Stevan Thompson ordered the defendant to pay $33,613 in restitution to the Idaho Department of Health and Welfare, a $500 fine, and $500 toward the cost of a public defender, Wasden said. Conica also was ordered to pay court costs.
An investigation revealed Conica had billed Medicaid and then misappropriated Medicaid funds that should have been used on clients’ behalf. This resulted in clients not receiving all of the required healthcare products Medicaid funding should have provided them. In some cases, patients were forced to use their own money to purchase products as a result of the gap created by Conica’s fraudulent behavior.
It also was discovered that Conica billed Medicaid for products, then provided patients with an entirely different product that was not covered by Medicaid, pocketing the difference for his own personal use.