Wisconsin Funeral Director Charged with Medicaid Fraud

A Wisconsin funeral director is charged with Medicaid fraud, forgery, and other charges related to a scheme to submit fraudulent claims for funeral expenses to the Wisconsin medicaid agency, according to a news release by the Wisconsin Department of Justice and Attorney General J.B. Van Hollen.

Wisconsin’s Program

Medicaid does not provide coverage for funeral expenses, but some states do so with their own funds. In Wisconsin, the Wisconsin Funeral and Cemetery Aids Program (WFCAP), provides coverage of funeral, burial, and cemetery expenses for Medicaid recipients funded by local county or tribal agencies when the estate lacks funds to cover them. The funeral home or cemetery submits claims for reimbursement to the county or tribal agency.

Allegations Against Patton

In this case, it was an application submitted to the Milwaukee County Department of Health & Human Services (MDHHS) that is at issue. Douglas L. Patton submitted an application for payment to MDHHS using inflated costs and a forged signature of the decedent’s next-of-kin.The WFCAP instructions state that the executor of the deceased’s estate or a family representative must sign the application. As a result, Patton received a payment of $1,500 for this claim.

Other allegations in the complaint against Patton include submitting claims for funeral services and burial goods that were not provided, such as charging for embalming, dressing, casketing, visitation, and related facilities and equipment when the deceased individual had not had a visitation or wake and was cremated rather than buried. The next-of-kin did not sign the application for these services either, and Patton allegedly received $2,010.44 for this false claim. Patton’s funeral business was also operated without a licensed funeral director, as required under Wisconsin statutes, for at least three years.

Investigation

This matter was brought by the Medicaid Fraud Control and Elder Abuse Unit of the Wisconsin Department of Justice (MFCEAU). The MFCEAU “investigates and prosecutes crimes committed against vulnerable adults in nursing homes and other facilities, as well as fraud perpetuated by providers against the Wisconsin Medicaid program.” Patton is presumed innocent of these charges until the prosecution proves them at trial. His initial court appearance is set for September 5, 2013.