Delaware prosecutors say a Milton woman, who worked as a biller for a licensed clinical social worker, has pleaded guilty to health care fraud and related charges after an investigation revealed she billed the state’s Medicaid program for fictitious office visits.
The state Department of Justice said Wednesday that 51-year-old Karen Fueyo pleaded guilty to one count of felony health care fraud, one count of felony theft and one count of felony second-degree conspiracy in Sussex County Superior Court. Judge E. Scott Bradley gave Fueyo a three year prison term suspended for probation. The judge also ordered Fueyo to pay full restitution to the Delaware Medicaid Program, in addition to fines and court costs, as well as the costs of investigation to the DOJ’s Medicaid Fraud Control Unit.
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Prosecutors said Fueyo worked as a biller for Rosa Fernandez, a licensed clinical social worker in Milton, who was also arrested and indicted in this case. Following an audit, the Delaware Division of Medicaid and Medical Assistance referred the matter to the Department of Justice Medicaid Fraud Control Unit. Prosecutors said the DOJ investigation showed Fueyo billed the Delaware Medicaid program for numerous office visits that never occurred, including dates when clients were out of the country.
Fernandez, who was also indicted on multiple counts of felony health care fraud, theft, falsification of business records, and felony conspiracy, is facing trial later this year, prosecutors said.
