Picture credit - WTHR

The Office of the Attorney General has announced that Adrian Mance entered a guilty plea to one count of Medicaid Fraud on October 30. A Hall County Judge sentenced Ms. Mance to serve 10 years of probation and pay restitution in the amount of $11,255.15.

“The public relies upon the honesty and integrity of individuals who participate in the Georgia Medicaid program,” said Attorney General Chris Carr. “Those who violate that trust must be held accountable, and I applaud the efforts of our Medicaid Fraud Division for investigating and prosecuting this case.”

Beginning in 2012, Ms. Mance utilized the “New Options Waiver Program” (NOW), a Medicaid waiver program, to employ a caretaker to provide personal support services to her sister. Ms. Mance, acting as her sister’s representative, enrolled in the Participant-Directed Services option of the program, which allowed her to pay the caretaker with funds obtained from Georgia Medicaid. In order to obtain these funds, Ms. Mance would fill out and sign timesheets that would then be submitted to Acumen Fiscal Agent (Acumen), a payroll services company utilized by the Georgia Medicaid program. Acumen would then deposit these funds directly onto a pay card intended to be payment for the caretaker’s services.

Ms. Mance submitted an address change form to Acumen requesting all of the caretaker’s mail be sent to the address at which Ms. Mance resided. From September 2011 until December 2014, Ms. Mance exercised control over the caretaker’s pay card.

Further investigation by the Georgia Medicaid Fraud Division determined that between February 1, 2013 and December 31, 2014, Ms. Mance submitted timesheets to Acumen claiming the caretaker was providing personal support services to her sister, yet no such services were provided. This resulted in Ms. Mance obtaining $11,255.15 in payments from the Georgia Medicaid program to which she was not entitled.

The preliminary investigation was conducted by Department of Community Health Program Integrity Investigator Cameron Daniels. The case underwent further investigation and was prepared for prosecution by the Georgia Medicaid Fraud Division: Chief Intelligence Analyst Tish Murray, Investigator Lee Thompson, Forensic Auditor Cecilia Isaac Vazquez, Nurse Investigator Nancy Dickerson and Intelligence Analyst Vanda Russell. The prosecution was conducted by Assistant Attorney General Jessica R. Hall.

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