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Evanston woman pleads guilty to Medicaid fraud

Posted: Friday, Jun 7th, 2013

Crime news

CHEYENNE An Evanston woman pleaded guilty Wednesday to defrauding the state Medicaid system of $56,000 by falsely claiming she provided services to children with developmental disabilities. The plea comes as state officials are wrestling with how to cut costs of the sprawling health care program while demand for services rises.

Brenda Murray entered the plea before U.S. District Judge Nancy Freudenthal in Cheyenne. The judge set sentencing for Aug. 14.

Both the prosecution and the defense say they expect to recommend that Murray, 52, receive probation. However, Freudenthal warned Murray that she could receive a sentence of up to 10 years in prison.

The indictment against Murray, filed in March, states that she defrauded the Wyoming Medicaid program from 2009 through May 2011. It states she was a certified provider under the Developmental Disabilities Waiver Program and falsely billed for services that she hadn't performed.

Murray told Freudenthal that she took care of special needs children for the program. "I billed for services I didn't provide," she said.

The judge told Murray she will have to make restitution.

The state Legislature this year directed the Wyoming Health Department to reform the Medicaid system to save money. The program serves more than 77,000 people in Wyoming at an annual cost of more than $500 million, split evenly between the state and federal governments.

The state will be forced to add thousands more people, most of them eligible children, to the Medicaid rolls under the federal Affordable Care Act starting next year. So far, the state has opted against an optional expansion that would extend benefits to thousands more low-income adults.

Murray's was among three Medicaid fraud cases the Wyoming Attorney General's Office announced in April. Charges are still pending in federal court against the other two defendants.

The Developmental Disabilities Waivers program subsidizes special services to children and adults to help them remain in their communities. The program is coming under increased scrutiny as costs and budget concerns rise.

The Legislature's Joint Labor, Health and Social Services Interim Committee heard testimony Monday from state Health Department officials at a meeting in Casper on ongoing studies to extend health care services to people on waiting lists for services under the waiver program.

Department director Tom Forslund told legislators Monday that families who receive services under the waiver program don't want to see it changed, while those on the waiting list for services favor extending it to them.

"The people who are on the waiting lists, who are there, are very supportive and want it to move forward," Forslund said of proposed changes, "because they can see a potential light at the end of the tunnel."

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