The Utah Attorney General’s Office recently charged a Medicaid provider with communications fraud and engaging in a pattern of unlawful activity. This case involved a Medicaid provider that was contracted to provide counseling services to incarcerated juveniles. Richard J. Garcia, a Licensed Clinical Social Worker, falsified billing records and submitted fraudulent claims to the state totaling at least $100,000.
The Utah Office of the Inspector General (UOIG) worked with partner agencies, including the Utah Attorney General’s Office, in identifying suspected claims submitted by Garcia. The UOIG utilized sophisticated data analysis systems and investigation techniques to identify abnormalities in Garcia’s billings. Once UOIG investigators were able to identify suspected fraudulent activity, the office worked with partner agencies in referring the case to the Utah Attorney General’s Office for further investigation and possible criminal charges.
With the announcement that charges have been filed against Garcia, taxpayers are further realizing the success of the UOIG in identifying fraud, waste, and abuse within the Medicaid system. The case of Garcia highlights the importance of maintaining a strong oversight activity for the Medicaid program. The UOIG conducts oversight of the program through audits, inspections, investigations, claims reviews, random sampling, and proprietary data analysis. For further information about the UOIG or to report suspected fraudulent activity, please contact us at (801) 538-6087.
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