Woman charged with swindling feds to boost prenatal-care program
A woman who once ran a health care clinic in West Valley City that served low-income clients is now facing federal charges on allegations she fraudulently enrolled expectant mothers in the Baby Your Baby program and charged for services the clinic never provided.
In a joint federal and state action, prosecutors allege LaRohnda Dennison, 48, who operated the WestView Community Health Center, illegally collected $1 million in Medicaid payments through the scheme. A federal grand jury in Utah issued a 22-count indictment Wednesday charging Dennison, who now lives in Denver, Colo., with health care fraud and making false statements. Also named as a defendant is All Medical Billing, which Dennison co-owned and which provided billing services for the clinic.
Attorney Tara Isaacson, who is representing Dennison, said Wednesday her client "denies any wrongdoing and we look forward to challenging the allegations in court."
Dennison and her mother, Goldie Dennison, founded the non-profit clinic, which also operated as the WestView Women's and Family Medical Center, in West Valley City in 2004. The two said the clinic was designed to serve low-income women whose health care needs were underserved in the area.
Many were enrolled in the Baby Your Baby program, which uses state and federal funds to provide two months of prenatal care to low-income, pregnant women who are waiting to see if they are eligible for Medicaid. Baby Your Baby participants must meet income guidelines and be a U.S. citizen or legal resident, but to encourage early prenatal care no proof of eligibility is required.
According to prosecutors, some of the clinic's clients were ineligible for the program. The indictment says Dennison and other staff "directed and coached pregnant aliens" to apply for the Baby Your Baby program by claiming they were U.S. residents, had green cards and by supplying fictitious Social Security or tax identification numbers.
The clinic then provided and billed Medicaid for office visits, prenatal ultrasounds and other pregnancy related services. But it also billed Medicaid for services that were never provided, such as urinalysis tests, the indictment alleges.
Prosecutors also say the clinic billed for ultrasound services that were not performed or were evaluated by an alleged radiologist from Mexico who was not licensed to practice medicine in Utah.
The indictment says the clinic required pregnant aliens to sign a contract that included a fine ranging from $1,200 to $1,800 if they did not use one of three preferred hospitals where its doctors held privileges; failed to apply for Emergency Medicaid in their third trimester or at the time of the delivery; or opted not to use the clinic during the pregnancy or for pediatric services.
The indictment lists 11 patients who described how and when they were coached to apply for the Baby Your Baby program, overseen locally by the Utah Department of Health, and for Emergency Medicaid.
In a 2008 Salt Lake Tribune story, Dennison said the clinic averaged between 125 and 150 patients a day, most of whom had no health insurance. She said two obstetricians affiliated with the clinic delivered about 35 babies a month. But funds were so short the clinic had not bought new pens in years, she said.
Since 1987, Utah has provided nine-digit identification numbers for women who applied for the Baby Your Baby program but did not have or know their Social Security number. A Tribune investigation in 2011 showed some identification numbers, including some used by patients the WestView clinic, matched existing Social Security numbers.
The state began looking into the WestView clinic in 2009 after noting an unusually high number of claims for ultrasounds being performed at the center through the Baby Your Baby program, but few of the women went on to qualify for Medicaid. The clinic closed in 2010 as the state investigation continued.
By 2011, state authorities alleged a clinic employee had coached thousands of undocumented immigrants to lie about their citizenship status to participate in the program.
That same year the health department modified its numbering system to avoid duplication of real Social Security numbers. It is set to start using 10-digit identification numbers in January when it switches over to a new computer system.