Attorney General’s Medicaid fraud control unit leads effort to recoup stolen money

PIERRE, S.D. (KEVN) - South Dakota’s Attorney General, Marty Jackley, recently announced that the office’s Medicaid Fraud Control Unit has successfully recovered over $477,000 in overpayments from Medicaid and Veterans Affairs. This achievement has also led to the indictment of one individual for theft of these funds.

“This extensive civil and criminal investigation has been the result of the excellent work by local, state, and federal agencies and law enforcement,” said Attorney General Jackley. “The important thing is stolen taxpayer money has been recovered.”

The Adult Day Center of the Black Hills, which provides daytime care and activities for adults with disabilities, has been embroiled in an overpayment scandal. Jessica Scott, a former board member of the center, is accused of modifying bill documents, which resulted in the overpayment of funds from the South Dakota Medicaid Program, the South Dakota Department of Veterans Affairs, and the South Dakota Department of Human Services.

Scott has been indicted on charges of Grand Theft, Submitting False Claims to Medicaid, and Perjury. She is presumed innocent under the U.S. Constitution.

“Individuals who submit fraudulent claims and false statements to federally funded programs put health care benefits for everyone at risk,” said Curt L. Muller, Special Agent in Charge with the U.S. Department of Health and Human Services, Office of Inspector General (HHS-OIG), which helped with the investigation. “We are committed to working with our partner agencies to hold accountable those suspected of defrauding Medicaid and other government programs.”

Recovered money will be used between the state Department of Veterans Affairs, the state Department of Social Services’ Medical Services program, and the state Department of Human Services.

“We are fortunate that Jes Scott’s actions have not interrupted the incredibly important services we provide to families in our community,” said Melanie Barclay, executive director of the Adult Day Center of the Black Hills. “Throughout the past year, we have worked very hard to strengthen our relationships with the State of South Dakota as well as the Veterans Administration. Our caregivers and guests depend on us for socialization opportunities, personal cares, community activities and respite, and we are committed to work tirelessly to continue to provide care.”

The South Dakota Medicaid Fraud Control Unit receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award totaling $615,068 for Federal Fiscal year FY 2024. The remaining 25 percent, totaling $205,019 for FY 2024, is funded by the state of South Dakota.