Pueblo County couple charged with million dollar Medicaid fraud related to speech therapy services

Apr. 2, 2019 (DENVER, Colo.) — Today Colorado Attorney General Phil Weiser filed charges against Frank and Melanie Palcic for allegedly defrauding the Colorado Medicaid program by billing for speech therapy services that were never provided.

Frank and Melanie Palcic operated Greenhorn Health Services and Southern Colorado Therapy Care, both located in Pueblo County. At the time, both companies were enrolled in the Colorado Medicaid program. The two are being accused of fraudulently billing the Medicaid program for speech therapy services that were not provided to juvenile Medicaid patients between 2014 and 2017.

An investigation by the Medicaid Fraud Control Unit of the Colorado Attorney General’s office found that the Palcics were reimbursed $1.5 million dollars by Medicaid for their services, even though roughly 70 percent of their claims did not have supporting documentation and did not occur.

“One of my top priorities as Attorney General is to fight for and protect access to health care, including through the Affordable Care Act’s Medicaid expansion. The expansion of Medicaid has lowered the rate of the uninsured individuals in Colorado, especially among children. In order to enable our youngest Coloradans to benefit from critical healthcare services, we must crack down on those who seek to take advantage of the system through criminal means,” said Weiser.

Roughly 40 percent of all children (opens new tab) in Colorado and 40 percent of all residents of Pueblo County receive Medicaid insurance. The benefits of Medicaid expansion are particularly clear and compelling in rural areas and small towns where the uninsured rate has dropped (PDF download) from 42 percent to 13 percent between 2008 and 2016. This expansion of access to health care insurance has also enabled rural hospitals to remain open in a difficult operating environment.

The Palcics were each charged on one count of theft, one count of conspiracy to commit theft, two counts of computer crime and two counts of conspiracy to commit computer crime. The Palcics are being held without bond in the Pueblo County Jail until their appearance at Pueblo County Court later today.

The Attorney General’s Medicaid Fraud Control Unit is dedicated to the investigation and prosecution of Medicaid provider fraud. The unit also investigates and prosecutes abuse of patients and residents in hospitals, nursing homes and board and care facilities. To report suspected Medicaid fraud or abuse, contact the AG’s Office at mfcu.investigations@coag.gov or (720) 508-6696.

The fact that a defendant has been charged with a crime is merely an accusation and the defendant is presumed innocent until and unless proven guilty.

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CONTACT
Lawrence Pacheco, Director of Communications
(720) 508-6553 office | (720) 245-4689 cell
Email: Lawrence.pacheco@coag.gov