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South Dakota Woman Ordered To Pay $76K In Wyoming Medicaid Fraud

in News/Crime

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By Ellen Fike, Cowboy State Daily

After being convicted in May of defrauding the Wyoming Medicaid program of tens of thousands of dollars, a South Dakota woman was sentenced late last week to prison in the incident.

Holli Telford Lundahl, 64, of Oelrichs, South Dakota, was sentenced by U.S. District Court Judge Nancy Freudenthal to two years and three months in prison, with three years of supervised release, and ordered to pay $76,626.65 in restitution to the Wyoming Medicaid program and a $500 supervised release.

“Lundahl deserves every bit of that sentence. She robbed Wyomingites of receiving legitimate funds for necessary care through Wyoming’s Medicaid System,” said Acting United States Attorney Bob Murray. “The sentence speaks to the hard work put into investigating and prosecuting the case, and we thank the Wyoming Medicaid Fraud Control Unit and our prosecution team for putting a stop to this injustice.”

A jury found Lundahl guilty on three counts of health care fraud and two counts of aggravated identity theft after a one-week trial held in April.

In March 2020, Lundahl was indicted on allegations that she ran three overlapping schemes to defraud Wyoming Medicaid by submitting false claims for long-term care provided to her sibling and the unlawful possession and use of identity information of two individuals, including Lundahl’s niece, in furtherance of two of the charged schemes.

The evidence at trial showed that Wyoming Medicaid operates a long-term care program designed to keep beneficiaries out of nursing homes and other institutional settings. This program provides limited payments for certain direct support services provided to beneficiaries by properly qualified and enrolled workers.

Lundahl, using her niece’s name, Social Security number and other identifying information, enrolled her niece in this program as a caregiver for Lundahl’s sister.

Lundahl then submitted claims to Wyoming Medicaid for direct support work she said was done by the niece when in fact the niece had not provided any services. Lundahl’s niece did not know her identity was being used and had never been to Wyoming before testifying at her aunt’s trial.

The false information provided by Lundahl caused Wyoming Medicaid money to be paid in the niece’s name into a credit union account controlled by Lundahl.

Evidence at trial also proved that Lundahl advertised for a direct support worker in Lusk. When a young woman responded to the ad, Lundahl convinced the woman to share her social security number and other identification information with Lundahl in order to be hired.

The woman worked one day, was paid cash for her time and was not asked to return.

Lundahl then used the young woman’s information to submit false claims to Wyoming Medicaid for direct support work that the woman did not perform.

As a result, Wyoming Medicaid money was paid in the young woman’s name into a credit union account controlled by Lundahl.

Finally, evidence at trial proved that Lundahl enrolled herself as a direct support worker However, she had the power of attorney for her sister and therefore could not be enrolled under Medicaid’s long-term care rules.

Lundahl then submitted claims to Wyoming Medicaid for direct support work when she was not eligible to be paid for this work and she received Wyoming Medicaid money when she was not eligible to receive such payments.

“It was nice to have the opportunity to partner together to root out Medicaid fraud and protect the Medicaid program from these sorts of abuses,” Wyoming Attorney General Bridget Hill said. “This is important work as it helps assure that the Medicaid program is available to provide medical care for those citizens who truly need it.”

The case was investigated by the Wyoming Medicaid Fraud Control Unit and prosecuted by Senior Assistant Attorney General Travis Kirchhefer of the Wyoming Attorney General’s Office and Assistant United States Attorney Eric Heimann.

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