News

Father, daughter steal $111,000 from Medicaid

 

Sequim Gazette staff

and Washington State Attorney General’s Office


A father and daughter from Sequim will serve 30 days in jail after pleading guilty to stealing $111,705 from state and federal health care programs.

 

The Washington State Attorney General’s Office announced Crystal Edgington and her father Jeffrey Edgington pleaded guilty July 12 in Thurston County Superior Court to four counts of theft each and multiple counts of submitting false statements/claims to Medicaid.

 

“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.

 

According to a news release, state prosecutors filed a series of Medicaid fraud-related charges in Thurston County Superior Court on March 19 against the Edgingtons. State investigators said from May 2008 to January 2012, the Edgingtons illegally billed Medicaid, receiving payments for services that Crystal Edgington didn’t actually provide to her mother, a client of the Department of Social and Health Service’s Community Options Program Entry System. The program funds in-home care for the poor. Under state and federal law, spouses can’t be paid care providers for each other.

 

Investigators said to circumvent the law, Jeff and Crystal Edgington devised a plot in which Crystal Edgington would be the paid provider of record and pass the money along to her father. Jeff Edgington used the funds to pay for his home on a Sequim golf course, season tickets to the Seahawks games and other expenses, according to the news release.

 

The DSHS discovered in October 2008 that Crystal Edgington was working another job while allegedly taking care of her mother. They notified the Medicaid Fraud Control Unit, which then discovered Crystal Edgington billed DSHS for allegedly providing in-home care to her mother in 2011 when her mother was actually in the hospital.

 

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, according to the news release.

 

Investigator Nancy Lewin, with the MCFCU, conducted the investigation along with assistance from Investigator Craig Brott and Auditor Sally Odiorne. Bashaw, MFCU Senior Counsel, prosecuted the case.

 

The Attorney General’s Medicaid Fraud Control Unit is responsible for the investigation and prosecution of health care 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.

 

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