Attorney General Gansler Secures Guilty Plea in Medicaid Fraud Case that Left Infant Patient in Unlicensed Care
Germantown nurse sent her unlicensed daughter to care for sick child, fraudulently billed Medicaid $41,000
Baltimore, MD (February 24, 2012) - Attorney General Douglas F. Gansler announced today that Licensed Practical Nurse Hellen Njeri Ngatia, 43, and her daughter, Gladys Muthoni Ngatia, 25, both of Germantown, pled guilty in the Circuit Court for Baltimore City to a scheme that placed a seriously ill 16-month-old infant in unlicensed care. For nine months, Hellen Ngatia submitted multiple Medicaid claims falsely stating that she had provided nursing services to the infant when in fact, care was provided by her unlicensed daughter.
"Stealing from Medicaid is disgraceful but stealing in a manner that puts a seriously ill baby at greater risk is inexcusable," said Attorney General Gansler. "The taxpayers were made whole again since the employer returned the $41,000 to Medicaid for Marylanders who need and deserve proper medical care."
Both mother and daughter pled guilty to Medicaid Fraud and Conspiracy to Commit Medicaid Fraud. Baltimore City Circuit Court Judge Michael W. Reed sentenced Hellen Ngatia to three years incarceration, suspending all but 90 days. She was placed on three years supervised probation and ordered to perform 150 hours of community service within 18 months. Gladys Ngatia was sentenced to three years incarceration, all of which was suspended. She was placed on three years supervised probation and ordered to perform 100 hours of community service within 18 months.
The investigation revealed that Hellen Ngatia was hired on April 19, 2009 by MBL Associates, a nurse staffing agency. She was to provide nursing care to a 16-month-old participant in the Rare and Expensive Case Management System, a Medicaid waiver program that is designed to provide health care to individuals with complex medical needs. Instead, Hellen Ngatia sent her unlicensed daughter to the client's home to care for the infant over the next nine months. Medicaid was billed for the services of a Licensed Practical Nurse and paid MBL Associates $41,258.56. The company self-reported the incident to the Board of Nursing and has returned the money to the Medicaid program.
Attorney General Gansler thanks Assistant Attorney General Catherine Schuster Pascale, Medicaid Fraud Control Unit Investigators Yvette Finney and Dean Brewer, and the Maryland State Police for their work on this case.