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Virginia State Seal as part of the letterhead for the Attorney General.

Commonwealth of Virginia
Office of the Attorney General

Mark Herring
Attorney General

900 East Main Street
Richmond, Virginia 23219

 

For media inquiries only, contact:  
Brian J. Gottstein
Phone: (804)786-5874 
Email: This email address is being protected from spambots. You need JavaScript enabled to view it. (best contact method)

MEMO to Media:  Roanoke Times story gets it wrong on AG's Medicaid fraud recoveries

RICHMOND (August 28, 2013) – This is a brief memo to media to clarify facts that were heavily distorted in a Roanoke Times article today on the OAG's Medicaid fraud recoveries under Attorney General Cuccinelli.

Reporter David Ress selectively chose statistics that didn't tell the whole story and tried to make the successes look smaller by dividing them up throughout the story.  His story’s premise:  The Medicaid fraud unit’s recoveries have declined since 2008, giving Virginia a 44th-place ranking among the states.  Ress’s premise is based on him deliberately neglecting to include the record-breaking $1.5 billion Abbott Labs case the unit cracked in 2012. 

The facts:

From the beginning of the Cuccinelli administration to today, the office's Medicaid fraud convictions have led to a RECORD $1.58 billion in court-ordered restitution, fines, and penalties.  That totals more in recoveries than all attorneys general COMBINED since the unit was created in 1982.  And the $1.5 billion Abbott case in 2012 was the LARGEST case ever investigated by a state.  No other state has even come close.

When Ress referred to a "ranking," he was referencing this OIG report, which is a one-year snapshot and not at all representative of the work we do:

1)  Ress was told it didn’t contain Virginia’s $1.5 billion Abbott Labs case we won in 2012 because the case won’t be reported on the government’s annual report until the government’s fiscal year ends on Sept. 30; and
2)  he can’t fairly compare single years.  There are certainly individual years where other MFCUs may recover more than we do in a single year, but to compare states, you have to look at five-year rolling averages, because the big cases take three or four years to investigate and prosecute.  After the four largest states in the country (California, Texas, New York, and Florida), no one else has recovered as much as Virginia has over the last three years, five years, or 10 years, period. 

Contrary to Ress's assertions, our collections are not in decline.  Instead, we are breaking records.  Look at year-by-year chart of Virginia MFCU recoveries on page 39 here.  Attorney General Cuccinelli’s recoveries are the highest in history – we even broke our own record which we set nationally in the 2007 Purdue Pharma case (the largest case in US history at the time).  And every single year during the Cuccinelli administration, we brought in more recoveries than any other single year in the office’s history before the Purdue case hit.

Our recoveries average $3.1 million per employee annually over the last five years.  Mr. Cuccinelli expanded the unit because adding employees is netting millions more dollars in recoveries for Virginia – we recover more stolen taxpayer dollars than we spend in additional salaries.

 

If you have any questions, please contact Brian Gottstein at This email address is being protected from spambots. You need JavaScript enabled to view it..

 
 
 
 
 
 
 
 
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Virginia State Seal as part of the letterhead for the Attorney General.

Commonwealth of Virginia
Office of the Attorney General

Mark Herring
Attorney General

900 East Main Street
Richmond, Virginia 23219



For media inquiries only, contact:  
Brian J. Gottstein
Phone: (804)786-5874 
Email: This email address is being protected from spambots. You need JavaScript enabled to view it. (best contact method)

In contrast to Washington, Cuccinelli's office returns part of budget to General Assembly at end of each fiscal year

RICHMOND (September 30, 2013) - Today, Sept. 30, is the end of the federal fiscal year. The Washington Post reported yesterday that amid the financial problems of the federal government, federal agencies still go on their annual spending sprees to use up their budget dollars before the end of the year so Congress will not reduce their future budgets.

As an example, the Post reported that one agency bought $562,000 worth of artwork last week.

This contrasts with how Attorney General Ken Cuccinelli has worked every year with a smaller General Fund budget (the discretionary part of his operating budget) than when he arrived in 2010, yet still returned part of his office's budget at the end of every year to the General Assembly.

AG's General Fund budget:
FY10    $19.6 million
FY11    $18.9 million
FY12    $19.3 million
FY13    $18.1 million
FY14    $18.1 million

The attorney general worked with this smaller budget by reallocating money to priorities and identifying efficiencies - including tighter budgeting and leaner spending, spending less on senior staff salaries and recruiting fewer senior staff members at the beginning of his administration, moving offices to consolidate space, and cutting travel.

Because of this fiscal management, even with a smaller General Fund budget, the attorney general has returned part of his operating budget to the General Fund each year.

Dollars returned to General Fund:
FY10    $635,504
FY11    $588,063
FY12    $578,522
FY13    $1,473,853

The one part of the office that was expanded

Responding to the increase in referrals of cases of Virginia taxpayers being defrauded through the Medicaid program, the one part of the office Cuccinelli expanded was the area that fights Medicaid fraud - a unit that recovers stolen tax dollars many times over what it spends on salaries. The Medicaid Fraud Control Unit (MFCU) recovers an average of $3.1 million in taxpayer funds per employee, and the more investigators and prosecutors hired, the more recoveries the unit is able to bring in. Cuccinelli took the staff from 56 to 96.

The MFCU expansion has already resulted in fraud recoveries totaling $1.58 billion during Cuccinelli's tenure - more than all attorneys general combined since the unit was created in 1982. It has also led to an increase in major cases currently under investigation.

 

The MFCU is 75 percent federally funded, with 25 percent of its funding coming from the commonwealth. As a result of the unit's aggressive investigations, the Virginia MFCU is the only unit in the country that has been able to negotiate that the penalties from its investigations be used to fund the state's share of its budget. The criminals, not the taxpayers, fund Virginia's portion of the unit. 

 
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Virginia State Seal as part of the letterhead for the Attorney General.

Commonwealth of Virginia
Office of the Attorney General

Mark Herring
Attorney General

900 East Main Street
Richmond, Virginia 23219



For media inquiries only, contact:  
Brian J. Gottstein
Phone: (804)786-5874 
Email: This email address is being protected from spambots. You need JavaScript enabled to view it. (best contact method)

Hampton mental health provider defrauded Medicaid for unnecessary services to children; state reclaims $1.5 million in fraudulent payments

NEWPORT NEWS (October 3, 2013) - A Hampton mental health service provider pled guilty earlier this week to a charge of health care fraud for falsely claiming that 66 Medicaid-eligible children she provided mental health treatment to actually needed it. She exaggerated or wholly invented their need for treatment to deceive Medicaid into approving payment for her services.

Attorney General Ken Cuccinelli, whose Medicaid Fraud Control Unit led the investigation, announced today that Delores F. Thomas, 54, owner of New Season Clinical Services in Hampton, pled guilty Monday to one count of health care fraud after a hearing before United States Magistrate Judge Tommy E. Miller.

"Delores Thomas not only stole $1.5 million from a program that serves the poor, but most disturbingly, she also used children as unwitting pawns in her scheme," said Cuccinelli.

Thomas faces a maximum penalty of 10 years of imprisonment when she is sentenced on January 17. She also agreed to pay $1,505,173 in restitution to the Virginia Department of Medical Assistance Services (DMAS), the state agency charged with overseeing the Medicaid program in Virginia. Thomas presented a check to the government for the full amount of restitution as part of a forfeiture proceeding in conjunction with the criminal charge.

Thomas owned and operated New Season Clinical Services, a Hampton-based Medicaid-contracted provider of intensive in-home services for children and mental health support services for adolescents and adults. Intensive in-home services are targeted and time-limited interventions for children who are at-risk of being removed from their homes due to significant behavioral or mental health issues. Mental health support services are designed to enable individuals with significant psychiatric functional limitations to achieve stability and independence in the most appropriate, least restrictive environment.

Thomas submitted false and fraudulent prior-authorizations for 66 Medicaid recipients, misrepresenting that 58 recipients required intensive in-home services and eight required mental health support services. As a result, Thomas received health care benefit payments from Medicaid in the amount of $1,505,173. Medicaid relies on the prior-authorization system to validate that the requested service is necessary and meets Medicaid criteria for reimbursement.

 

The Virginia attorney general's Medicaid Fraud Control Unit, the Federal Bureau of Investigation, and the U.S. Department of Health and Human Services - Office of the Inspector General investigated the case. Virginia Assistant Attorney General and Special Assistant United States Attorney Joseph E.H. "Eric" Atkinson and Assistant United States Attorney Robert E. Bradenham, II prosecuted the case. 

 
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Virginia Attorney General.

Commonwealth of Virginia
Office of the Attorney General

Mark Herring
Attorney General

900 East Main Street
Richmond, Virginia 23219

 

For media inquiries only, contact:  
Brian J. Gottstein
Phone: (804)786-5874 
Email: This email address is being protected from spambots. You need JavaScript enabled to view it. (best contact method)

Local sheriffs and police chiefs get $4.2 million from AG for training for crisis situations involving those with mental illnesses

** Breakdown of funds and programs by locality included.  Photos of localities receiving checks included **

- Money comes During Mental Health Awareness Week, comes from AG's Medicaid fraud settlement with Abbott Labs -

RICHMOND (October 9, 2013) - Today Attorney General Ken Cuccinelli held a news conference in Richmond with local sheriffs and police chiefs from around the commonwealth to present them with checks totaling $4.2 million for training to help law enforcement better respond to crisis situations involving individuals with mental illnesses.

Law enforcement, other first responders, and corrections personnel routinely interact with people with mental illnesses. Crisis Intervention Team (CIT) training provides tools to safely deal with those with mental illnesses and also helps those who are ill get proper care by helping first responders understand the circumstances surrounding mentally ill offenders.

Currently, more than 25 percent of the statewide jail population has been diagnosed with mental health issues and more than 12 percent were diagnosed with serious mental illnesses.

CIT training

  • increases public safety through better identification of, intervention with, and access to services for individuals with mental illness;
  • reduces injuries to law enforcement when dealing with these citizens and helps them de-escalate potentially volatile situations; and
  • teaches law enforcement where they can refer people for mental health services in lieu of incarceration, when appropriate.

"I learned how important this training was for law enforcement and for those with mental illnesses when I served as a court-appointed attorney in Virginia's involuntary civil commitment process. I worked first-hand with these types of folks and their families. Most need help, not jail time," said Cuccinelli.

The attorney general stressed that this money was coming from criminals, not the taxpayers. In 2012, Cuccinelli's Medicaid Fraud Control Unit was the lead investigator in the second largest Medicaid fraud settlement in U.S. history.  The $1.5 billion Abbott Laboratories fraud case resulted from the company's illegal marketing of its drug Depakote for uses not approved safe and effective by the Food and Drug Administration.

On top of the restitution to the state's Medicaid program, the office earned $115 million in asset forfeiture funds as lead investigator in the case. The attorney general said he wanted to share $105 million of those funds with state and local law enforcement. This $4.2 million is the first part of that commitment.

Click here for a list of individual localities' proposals for using the money and the amounts they received. Grant amounts for each locality were based on proposals submitted by the agencies.

Click here for photos of police and sheriffs' departments receiving checks today. The pictures are captioned with identification of the people in the shots. You are free to use the photos online, in print, or on air in articles related to this story. To download from Flickr, click on a thumbnail of a photo, then right click on the photo to bring up a menu. In the menu, click on a size you want to view, and a download link will appear.  

Additional information:

The single largest grant was for $800,000 to the Virginia Department of Criminal Justice Services (DCJS) to provide training for localities that do not have their own CIT programs. DCJS is responsible for implementing programs and initiatives to improve the functioning and effectiveness of the commonwealth's criminal justice system.

Since 1997, when he was in private practice, Cuccinelli served as a court-appointed attorney for individuals with mental illnesses in Virginia's involuntary civil commitment process. After joining the Senate in 2002, he successfully sponsored legislation that provided for more humane treatment of the mentally ill.

 

In 2008, working in a bipartisan manner, he pushed through a bill to ease the process for involuntary commitment, to restrict gun ownership rights for those with mental illnesses, and to help break down barriers for sharing information between doctors and the court system.