REFERRAL OF CREDIBLE ALLEGATION OF FRAUD
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Name(s) of legal reviewers
- 1. Howard Pallotta 2. Nicole Nantois 3. Jerry Streck 4. Becki Burton
Additional Exhibits Attached:
- Investigator’s report 2. Voluntary statement from Jeff Lloyd 3. Voluntary statement from Constance Lindley 4. Voluntary statement from Emest Cummings 5. Voluntary statement from Randy Crownover (including internal documents provided by
Mr. Crownover) 6. Voluntary statement from Cheryl Hunter (sent via e-mail) 7. May 16, 2013 Termination Letter
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Please provide any relevant notes or comments of legal reviewer‘s): The attorneys listed above met numerous times to discuss the referral received from PI regarding Janice Briggs. We believed the issues presented were indicative of fraud, but because it was an outside referral and the informants were past employees, we wanted to have an investigator follow–up to verify the credibility of the witness. We were already aware of problems involving the billing of H2017 on children under 5, and a referral on this issue had already been made. This is also why we wanted to get further confirmation on the new claims.
Investigator Travis Kirkpatrick was able to interview 5 former employees. The employees were consistent in their testimony and appear to be reliable witnesses. Travis was also able to obtain written statements from the witnesses. Travis also has recordings of most of the conversations he had with potential witnesses, which can be made available upon request.
Upon completion of Travis‘ investigation, the attorneys named above believed fraud was being committed and determined it was in the best interest of the Medicaid program to terminate the provider’s individual and group contracts.
THE OKLAHOMA HEALTH CARE AUTHORITY
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Signature:
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By (print name): Jeremiah L. Streck
Title: Deputy General Counsel
Subscribed and sworn to before me this 10th day of June, 2013.
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Notary Public H olina My CommissierEE
# 13000554 SPALJ17/17
fbeeldic intent to defraud is required (63 O.S. 8 5053.1; 31 U.S.C.A. § 3729(b)(1)(B)
Revised 04-02–2012
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