State charges Milwaukee provider with Medicaid fraud exceeding $2 million

A courtroom and a judge's gavel. (Getty Images creative)
A Milwaukee provider of personal care services has been charged with bilking Wisconsinβs Medicaid program of almost $2.2 million, the state Department of Justice announced Wednesday.
Debbie Long, 44, was charged with billing Medicaid for services that didnβt take place, according to the criminal complaint filed Tuesday.
The complaint also charges Long inflated the size of the payroll and workforce at her home health business to obtain a $219,072 loan under the Paycheck Protection Program enacted to help businesses that had to temporarily shut down early in the COVID-19 pandemic.
In addition, the complaint alleges she purchased businesses and a luxury car with proceeds, using a series of shell companies to conceal where some of the funds came from.
Longβs business, Pinnacle Home Health Care LLC, submitted reimbursement claims for services purportedly provided to Medicaid members between March 2017 and August 2022, according to the complaint. DOJ investigators reviewing those submissions found at least $2.1 million in Medicaid reimbursements to Pinnacle for services that werenβt performed, the complaint charges.
The complaint says the allegedly fraudulent billings included βimpossible or improbable hours of service,β such as a personal care worker who reportedly worked more than 12 hours on a single day for one Medicaid member.
There were also reimbursements for services that were never provided, according to the complaint, for services that were more than workers provided, for services in which the Medicaid memberβs need was βmisrepresented,β and for services when the Medicaid member was in the hospital or incarcerated β situations in which members werenβt eligible for Medicaid reimbursement.
The investigation included interviews with Medicaid recipients as well as personal care workers employed by the business who helped investigators uncover some of the allegedly false information provided, according to the complaint.
Long is charged with five felony counts: theft by false representation greater than $10,000, fraud against a financial institution greater than $100,000, wire fraud against a financial institution, and two counts of money laundering greater than $100,000.
Court records reviewed Wednesday did not list an attorney for Long.
GET THE MORNING HEADLINES.