AG Gansler: Plea Ends Mother-Daughter Medicaid Fraud Case
16-month-old child put at risk by unlicensed nursing care
Baltimore, MD ( April 16, 2013) - Attorney General Douglas F. Gansler announced today the conclusion of a mother-daughter Medicaid fraud case that put the wellbeing of a 16-month-old child at risk. Gladys Muthoni Ngatia, 26, of Germantown, pleaded guilty to felony theft for submitting a series of false claims to Medicaid for services that were supposed to be provided by her mother. Baltimore City Circuit Court Judge Michael W. Reed sentenced the defendant to 364 days incarceration, suspending all but 216 days, representing time served. Judge Reed placed Ngatia on 5 years supervised probation, ordered that she refrain from providing services under the Medicaid Program for five years, and ordered her to perform 100 hours of community service.
"Every Marylander in need of medical care should be able to feel confident that the person treating them is a trained and licensed professional," said Attorney General Gansler. "In this case, we saw a licensed nurse and her unlicensed daughter profit from fraudulent acts that threatened a vulnerable child's health and wellbeing."
Ngatia had falsely represented that her mother, Licensed Practical Nurse Hellen Njeri Ngatia, had provided services to a Medicaid recipient when in fact, the defendant provided the services. The defendant was not a Licensed Practical Nurse at the time. The mother pleaded guilty last year to Medicaid Fraud and Conspiracy to commit Medicaid Fraud and was sentenced to three years in the Division of Corrections, all but 90 days suspended, plus three years supervised probation and was ordered to perform 150 hours community service within 18 months.
The investigation revealed that in April 2009, Hellen Ngatia was hired by MBL Associates, a nurse staffing agency, to provide nursing care to a 16 month old participant in the Rare and Expensive Case Management System, a Medicaid waiver program that provides health care to individuals with complex medical needs. Instead of providing the nursing services herself, the licensed nurse sent her unlicensed daughter to the client's home to provide the nursing care.
Medicaid was billed for nine months worth of nursing services and paid MBL associates $41,258.56 for care not provided by a licensed practical nurse. MBL self-reported the incident to the Board of Nursing and has returned the money to the Medicaid program.
In making the announcement, Attorney General Gansler thanked 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.