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Pueblo County couple charged with million dollar Medicaid fraud

Posted at 3:40 PM, Apr 02, 2019
and last updated 2019-04-02 19:43:27-04

DENVER – Tuesday, Colorado Attorney General Phil Weiser filed charges against a Pueblo County couple.

According to the Attorney General’s office, Frank and Melanie Palcic are facing charges for allegedly defrauding the Colorado Medicaid program by billing for speech therapy services that were never provided.

The Attorney General’s Office said the couple operated Greenhorn Health Services and Southern Colorado Therapy Care, which are both located in Pueblo County.  At the time, both companies were enrolled in the Colorado Medicaid Program.

According to the Attorney General’s Office, the couple is being accused of fraudulently billing the Medicaid program for speech therapy services that were not provided to juvenile Medicaid patients between 2014 and 2017.

The AG’s office said an investigation by the Medicaid Fraud Control Unit found that the Palcics were reimbursed $1.5 million by Medicaid for their services, even though roughly 70 percent of their claims did not have supporting documentation and did not occur.

“One of my top priorities as Attorney General is to fight for and protect access to health care, including through the Affordable Care Act’s Medicaid expansion. The expansion of Medicaid has lowered the rate of the uninsured individuals in Colorado, especially among children. In order to enable our youngest Coloradans to benefit from critical healthcare services, we must crack down on those who seek to take advantage of the system through criminal means,” said Weiser.

According to the AG’s office, roughly 40 percent of all children in Colorado and 40 percent of all residents of Pueblo County receive Medicaid insurance.

The Palcic’s were each charged on one count of theft, one count of conspiracy to commit theft, two counts of computer crime, and two counts of conspiracy to commit computer crime, according to the AG’s office. Both are being held without bond in the Pueblo County jail until their appearance at the Pueblo County Court later Tuesday.