2 Utah Healthcare Suppliers Accused of Medicaid Scams

ST. GEORGE– The previous nursing director and the personnel’s director of Southwest Utah Public Health Department have both been accused of Medicaid scams.

Todd Alan Stirling, 51, of Washington City, and Russell Amon Hinton, 38, likewise of Washington City, were each charged in 5th District Court Monday with taking part in a pattern of illegal activity, a second-degree felony, in addition to being charged under the Utah False Claims Act, a second-degree felony.

From about October 2015 to February 2016, Stirling and Hinton “poorly triggered over 1,300 incorrect claims to be sent to the Utah Department of Health, Targeted Case Management program, for follow-up calls supposedly made to Medicaid receivers,” inning accordance with charging files.

Because of those sent claims, Medicaid funds were provided to the Southwest Utah Public Health Department “for services which were entirely or partly incorrect considered that they were not offered in compliance with Medicaid policy, were either never ever offered or were not supplied as billed, and/or were not clinically required,” the charges state.

The charges likewise declare that Stirling was funneling clients to his own personal business.

He “developed a company by the name of Feel Good Management LLC (a company formed in Delaware) and used this company to employ staff members, reach Medicaid receivers, send incorrect billings to SWUPHD and trigger incorrect claims to be sent to the Medicaid program,” the charges state. “(Stirling) got payments from SWUPHD for the over 1,300 incorrect claims that were paid by Medicaid, along with for over 3,000 extra claims that (he) sent to SWUPHD, but which were not paid by Medicaid.”.

Charging files likewise kept in mind that Hinton “benefitted economically from his participation with this business as he made it possible for his better half, Megan Hinton, to be paid by Feel Good Management and/or as he got payment straight from the company.”.