AG's Office Wins Major Medicaid Fraud Cases

posted Apr 24, 2012, 10:34 AM by Zack Freeman   [ updated Apr 24, 2012, 10:34 AM ]

AG's Office Wins Major Medicaid Fraud Cases...Las Cruces Corporation & 3 Individuals Found Guilty Tuesday, November 15, 2011 


(LAS CRUCES)---Prosecutors from Attorney General Gary King's office were successful obtaining guilty verdicts against a Las Cruces Medicaid provider and four individuals on Medicaid Fraud and other charges.

Counseling and Mediation, LLC, and Arcilia Holguin, the owner of Counseling and Mediation, were indicted in April 2010 on various counts of Medicaid Fraud, Fraud, and other related charges. Testimony at trial showed that Ms. Holguin and her employees were failing to provide the services they had contracted with Medicaid to provide, altering documentation to make it look like they were providing an appropriate service, and billing outrageous amounts of time for providing certain services.

Arcilia Holguin and Counseling and Mediation Services, LLC, were tried by a jury the first week of November, and were each found guilty on all the counts. Holguin was found guilty of Medicaid Fraud - Falsification of Documents (a fourth degree felony), Fraud over $20,000 (a second degree felony offense), Medicaid Fraud - Excessive Claims (a fourth degree felony offense), Medicaid Fraud - Substantially Inadequate Treatment over $20,000 (a second degree felony offense), and Fraud (over $20,000). Counseling and Mediation, LLC, was found guilty on similar charges. AG prosecutors showed that Ms. Holguin and Counseling and Mediation, LLC, overbilled Medicaid in the amount of $218,132.38. The corporation is also potentially subject to $500,000 worth of fines for the felony convictions, based on the Medicaid Fraud statute Section 30-44-7 (G). Holguin has 36 years exposure to jail time and the AG's office will recommend restitution, although sentencing has not yet been scheduled.

"It is not often that a corporation is found guilty in Medicaid fraud cases so this is a great win for the people of New Mexico and hopefully serves as a warning for other providers," says AG Gary King. "I congratulate our Medicaid Fraud & Elder Abuse Division staff for their perseverance and ability to take these cases all the way."

The other defendants, Lazaro Molina and Juana Barba, of El Paso, TX., were found guilty earlier this year on Medicaid Fraud and related charges. Penalties included incarceration, probation, and restitution.