Daughter frequently billed Medicaid while father splurged on a new home, Seahawks tickets
OLYMPIA — Today the Washington State Attorney General’s Office announced that the husband and daughter of a home-healthcare program client will serve jail time for stealing $111,705 from state and federal health care programs.
“This was a significant case of fraud and justice was served,” said Senior Counsel Carrie Bashaw of the Washington State Attorney General’s Medicaid Fraud Control Unit (MFCU).
On March 19, state prosecutors filed a series of Medicaid fraud-related charges in Thurston County Superior Court against Jeffrey and Crystal Edgington, of Clallam County. Jeffrey Edgington Thursday pled guilty to four counts of theft and four counts of Medicaid false claim. Crystal Edgington pled guilty to four counts of theft and two counts of Medicaid false statement.
As part of the plea, both Edgingtons, who are first time offenders, will serve 30 days in jail, followed by six months of Community Custody, and will be ordered to repay the Medicaid program $111,705 plus $800 in fines and court fees.
From May 2008 to January 2012, state investigators say the Edgingtons illegally billed Medicaid, receiving payments for services that Crystal didn’t actually provide to her mother, a client of the Department of Social and Health Service’s (DSHS) Community Options Program Entry System (COPES), which funds in-home care for the poor. Crystal Edgington in turn gave the Medicaid money to her father. Under state and federal law, spouses can’t be paid care providers for each other. Instead, Jeff and Crystal Edgington devised a plot in which Crystal would be the paid provider of record and pass the money along to her father. Jeff used the funds to pay for his home on a golf course in Sequim, Seahawk’s season tickets and other expenses.
In October, 2008 DSHS made the MFCU aware of the suspicious activity when they discovered that Crystal was working another job while allegedly also taking care of her mother. MFCU Investigator Nancy Lewin then discovered that Crystal had billed DSHS for allegedly providing in-home care to her mother in 2011, even though her mother was actually in the hospital at the time.
MFCU Investigator Nancy Lewin conducted the investigation along with assistance from Investigator Craig Brott and Auditor Sally Odiorne. Carrie Bashaw, MFCU Senior Counsel, prosecuted the case.
The Attorney General's Medicaid Fraud Control Unit is responsible for the investigation and prosecution of healthcare provider fraud committed against the state’s Medicaid program. In addition, the unit coordinates the investigation and prosecution of abuse and neglect involving vulnerable adults residing in Medicaid funded residential facilities with local law enforcement authorities through a statewide contact network
Janelle Guthrie, Director of Communications, (360) 586-0725