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Milton Woman Pleads Guilty to Health Care Fraud

Department of Justice | Fraud | Date Posted: Wednesday, March 25, 2015



Karen Fueyo, 51, of Milton, a former employee of a licensed clinical social worker, pled guilty to one count of felony health care fraud, one count of felony theft and one count of felony conspiracy in the second degree in Sussex County Superior Court. She was sentenced by Judge E. Scott Bradley to three years of incarceration suspended for probation, and ordered to pay full restitution to the Delaware Medicaid Program, in addition to fines and court costs, as well as costs of investigation to the Department of Justice Medicaid Fraud Control Unit.

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. 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.

“With Medicaid costs representing a major piece of the state budget, it’s crucial that cases like this be identified, investigated, and prosecuted,” said Attorney General Matt Denn. “I thank Deputy Attorney General Andrea Rodgers and Special Investigator Tom Abram for their work. I have talked about the importance of Medicaid fraud cases like these and we commit to continue bringing cases like these.”

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.

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Milton Woman Pleads Guilty to Health Care Fraud

Department of Justice | Fraud | Date Posted: Wednesday, March 25, 2015



Karen Fueyo, 51, of Milton, a former employee of a licensed clinical social worker, pled guilty to one count of felony health care fraud, one count of felony theft and one count of felony conspiracy in the second degree in Sussex County Superior Court. She was sentenced by Judge E. Scott Bradley to three years of incarceration suspended for probation, and ordered to pay full restitution to the Delaware Medicaid Program, in addition to fines and court costs, as well as costs of investigation to the Department of Justice Medicaid Fraud Control Unit.

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. 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.

“With Medicaid costs representing a major piece of the state budget, it’s crucial that cases like this be identified, investigated, and prosecuted,” said Attorney General Matt Denn. “I thank Deputy Attorney General Andrea Rodgers and Special Investigator Tom Abram for their work. I have talked about the importance of Medicaid fraud cases like these and we commit to continue bringing cases like these.”

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.

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