Colorado Medical Provider Convicted of Medicaid Theft

Colorado Attorney General John Suthers announced today that an occupational therapist from Castle Rock has been convicted of stealing from the state’s Medicaid program. Here are the details.

* The Medicaid Fraud Control Unit of the Office of the Attorney General initiated an investigation of Cheryl Moss, a 47-year-old occupational therapist, following a citizen complaint alleging that she had improperly billed the Medicaid program.

* The investigation revealed 83 forged treatment records that were meant to support fraudulent bills to the Colorado Medicaid Program, the Attorney General’s Office reported.

* Medicaid paid Moss for services she never rendered, based on forged invoices for payment that were submitted between November 2009 and August 2011.

* Moss pleaded guilty to one count of felony theft and one count of felony forgery. She has been ordered to repay the Colorado Medicaid Program $ 54,332 in criminal restitution and will serve 60 days in-home detention and 300 hours of community service. She will pay all fees and court costs resulting from the case, the Attorney General’s Office stated.

* In addition, Moss has agreed to pay the Medicaid program $ 46,000 in order to resolve any potential civil issues and is required to report her conviction to the Colorado Department of Regulatory Agencies, which is the state department responsible for licensing occupational therapists.

* The Colorado Medicaid Fraud Control Unit consists of criminal investigators, an auditor, a nurse investigator and prosecutors experienced in criminal and financial investigations.

* The Colorado Department of Regulatory Agencies reported that, as of fiscal year 2010-11, there were 2,497 registered occupational therapists statewide.

* Occupational therapy, as defined by the Colorado legislature, is the therapeutic use of everyday life activities with individuals or groups for the purpose of participation in roles and situations in home, school, workplace, community and other settings, the Department of Regulatory Agencies stated. Occupational therapists work with clients who may be mentally, physically, developmentally or emotionally impaired and occupational therapists help those individuals to develop, recover or maintain daily living and work skills.

* According to a report by Colorado Health Institute, around 65-70 percent of the licensed medical providers in Colorado accept Medicaid. Analysis from the institute found that Medicaid expansion authorized by the Affordable Care Act will create the need for an additional 83 to 141 primary care providers to care for the newly insured.

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