AG Curtis Hill Joins Federal Authorities In Complaint Against Physicians Over False Medicaid Claims 3456
A husband-and-wife physician duo exaggerated the number of urine samples they collected in order to overbill Indiana Medicaid by more than $1.1 million, according to a civil Medicaid fraud complaint filed today in U.S. District Court in the Northern District of Indiana.
Indiana Attorney General Curtis Hill and U.S. Attorney Thomas L. Kirsch II today announced the filing against former physicians Don J. Wagoner and Marilyn L. Wagoner. The complaint also applies to the following businesses: Wagoner Medical Center, L.L.C.; Wagoner Medical Center, P.C.; and Don J. Wagoner, M.D. and Marilyn L. Wagoner, M.D., P.C.
Working in the communities of Burlington and Kokomo, the Wagoners filed false claims from 2011 to 2013 in order to receive more money than they were entitled, according to the complaint. The couple billed Indiana Medicaid $171.27 per patient for collecting urine samples when Medicaid rules only allowed them to bill $20.83 per patient.
The Wagoners concealed their fraudulent activity by reporting they collected and analyzed nine or more urine samples from each patient when, in fact, they only had collected and analyzed one sample per patient, according to the complaint. The defendants followed this deceptive practice over the course of 6,400 separate claims.
The federal False Claims Act and the Indiana Medicaid False Claims Act allow the federal government and the State of Indiana to recover three times the amount of the false and fraudulent claims submitted to Indiana Medicaid — plus a civil penalty of $5,500 to $11,000 per false claim submitted. A small portion of recoveries under the federal False Claims Act (3 percent) is used to fund the cost of future health care fraud investigations and cases. Maximum possible recovery, then, would exceed $70 million.
“Working to recover taxpayer funds taken through fraud and other illegal means is part of our responsibility as stewards of the public trust,†said Attorney General Hill. “We appreciate the collaboration of our federal partners in this particular case, and we intend to remain vigilant going forward to make sure monies set aside to help society’s most vulnerable members are truly used for that purpose.â€
This complaint against the Wagoners does not represent the first time the two former physicians have found themselves at odds with state authorities. In 2013, these same defendants permanently surrendered their licenses to prescribe drugs and to practice medicine following a state criminal investigation of their opioid-prescribing practices, which resulted in felony drug dealing convictions of defendant Don J. Wagoner.
“Although they no longer are endangering vulnerable Medicaid patients by practicing medicine, former physicians Don Wagoner and Marilyn Wagoner cannot be allowed to retain the fruits of their fraudulent Medicaid claims,†said U.S. Attorney Kirsch. “My office will continue to make it a priority to pursue investigations and cases to recover funds that were fraudulently received from the Medicare and Medicaid programs. The Justice Department’s Commercial Litigation Branch has given a high priority to civil prosecution of health care fraud, including Medicare and Medicaid fraud.â€
The suit results from an investigation by the Indiana Medicaid Fraud Control Unit and the U.S. Attorney’s Office for the Northern District of Indiana.
“THAT’S MY STORY …†By Jim Redwine
GAVEL GAMUTÂ By Jim Redwine
“THAT’S MY STORY â€
Before the scales fell from my eyes my big sister would use me as a test subject for her early cooking experiments. In the summers before I started first grade Janie would order me to sit at an imaginary table and eat what Janie imagined to be food. The table was actually the sun-baked Oklahoma dirt and the food was pies she mixed up using that same dirt, water from a garden hose and bird eggs she stole from furious sparrows. Actually the mud pies tasted about as good as some of our neighbor lady’s homemade lye soap Janie also told me was fudge.
As I matriculated to grade school Janie was involved in Home Economics in high school. Now her cooking was for credit and as she was always our parents’ favorite I and our other two brothers were expected to test her culinary concoctions and rave about them. This was hard to do when most of what she tried to feed me got slipped to the dog under the table. I particularly remember being force fed something Janie called orangey coated biscuits. The dog had a problem for three days.
Now before you conclude I blame my sister for my addiction to packaged foods let me say Janie somehow managed to make herself into a fine gourmet cook – after she left home! Her erstwhile mud pies are now delicious brownies and her ghastly orange biscuits are now wonderful home baked breads. Of course, since I only get her current creations as Christmas gifts, she has quite a bit more to atone for.
This Christmas Janie sent Peg and me an assortment of Grandma’s sour cream fudge, Mom’s peanut brittle and Janie’s own original chocolate chip cookies. She had carefully packaged them and sent them to us via FedEx. We could tell Janie had filled the offerings with labor and love. Unfortunately, the FedEx driver went beyond the call of duty when he delivered the box to our rural home. He pushed it through the pet door of our garage in an effort to protect it from the elements and varmints.
When I got home from work I pushed the button to raise the garage door that also contains the pet door. I was looking straight ahead when I felt the left front tire roll over an object on the garage floor. Naturally I backed up and ran over it again. The contents of the box I ran over twice reminded me of those happy days of childhood. However, the mashed up goodies tasted a great deal better than the scrambled sparrow eggs. Janie need never know!
For more Gavel Gamut articles go to
Vectren Issues Safety Reminders For The Winter Heating Season
As the frigid air pushes its way into southwestern Indiana, Vectren Energy Delivery (Vectren) wants to remind customers to be aware of heating safety throughout the winter months. Having a furnace tune-up by a professional; knowing how to prevent carbon monoxide poisoning and detect a gas leak; and being aware of the safety precautions associated with the use of space heaters are simple ways to keep your household safe throughout the year.
“As temperatures continue to drop and the need for heating your home increases, it’s important to keep safety in mind,†said Brad Ellsworth, president of Vectren Energy Delivery-South. “Safety begins with simple steps such as ensuring your furnace and fireplaces are properly ventilated and the batteries in your smoke detectors and carbon monoxide detectors are in good working condition.â€
Customers should consider safety precautions associated with home heating, the use of natural gas and the use of electric space heaters. Furthermore, remember to change the batteries in smoke alarms and carbon monoxide detectors throughout the home on an annual basis.
Space Heater Safety
To help prevent fires and carbon monoxide (CO) poisoning from the use of space heaters, adhere to the following tips:
- Install and use appliances according to the manufacturer’s instructions.
- Consider using space heaters with automatic shut-off capabilities.
- Never use unvented gas or kerosene heaters in closed spaces, especially sleeping areas.
- Don’t use gas appliances such as an oven, range or clothes dryer to heat the home.
- Leave a window cracked about an inch for ventilation and fresh air. Ventilation is important to keep fuel-burning space heaters from consuming too much oxygen in the house.
- Do not leave a space heater on when you are not in the room or when you go to sleep and keep small children away from the unit at all times.
- Electric space heaters should be checked for signs of fraying or splitting wires or overheating. Likewise, electric space heaters frequently cause fires by overloading electrical outlets.
- Keep space heaters away from combustible materials/products.
- When selecting a space heater, look for one that has been tested and certified by a nationally recognized testing laboratory. These heaters have been determined to meet specific safety standards, and manufacturers are required to provide important use and care information to the consumer.
 Carbon Monoxide Safety
Carbon monoxide (CO) is a toxic gas produced by the incomplete burning of different fuels including gasoline, kerosene, wood, coal, propane, natural gas and fuel oil. High concentrations of CO can cause illness and excessive levels can be fatal. If you suspect CO in your home, get fresh air immediately and call 911. To prevent CO in your home:
- Make sure all appliances are properly installed and maintained and have a heating professional clean and check your heating and venting system every year.
- Check vents, flue pipes and chimneys for corrosion or blockage.
- Never run a vehicle or fuel-burning equipment in an enclosed place.
- Install at least one CO detector near sleeping areas to add an extra measure of safety.
If you smell natural gas
Natural gas contains an odorant called mercaptan that smells like rotten eggs or sulfur. In the event a gas leak is suspected inside of a home or business, residents are reminded of the following:
- Leave the home or business of the gas leak immediately and distance yourself from the building once outside, as well as areas where the odor of gas is noticeable.
- Do not use the phone, cell phone, or text anyone while in the building or who may be in the building. If you notice the leak while talking on the phone, do not hang up.
- Do not turn any lights, appliances or any electrical sources on or off.
- Do not light matches.
- Do not open or close windows.
- Do not start a vehicle if it’s parked in a garage that’s attached to the home/business of the suspected leak nor utilize an automatic garage door opener upon exiting.
- The activities listed above could trigger an ignition if gas has significantly accumulated.
- Call Vectren at 1-800-227-1376 from somewhere other than the location of the gas leak.
- Remain in a safe area until emergency personnel arrive and do not re-enter the premises.
Please note: There is no charge to the customer for calling Vectren to inspect a potential gas leak. Vectren will respond 24 hours a day, 365 days a year.
In the event a gas line has been struck or odor detected outside of a home or business, residents are reminded of the following:
- Leave the area of the gas leak immediately and distance yourself from source of the odor/struck line, as well as areas where the odor of gas is noticeable.
- Do not attempt to re-start or move powered equipment.
- Call Vectren at 1-800-227-1376 from somewhere other than the location of the gas leak. The party responsible for the damage to the gas line should also call 911 and report the incident to police and/or fire officials and the state’s 811 center.
- Remain in a safe area until emergency personnel arrive and do not enter the home/business or neighboring premises.
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HOT JOBS IN EVANSVILLE
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Breaking News: Investigators Looking into Cause of Evansville House Fire
When fire crews arrived they saw heavy smoke coming from the roof. Fire officials say two people passing by ran into the home to alert anyone inside, but the home was empty.
Crews quickly put out the flames in the roof.
There were no injuries.