1 AFFIDAVIT in SUPPORT of ARREST WARRANT Background
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AFFIDAVIT IN SUPPORT OF ARREST WARRANT Background. Your affiant is currently employed as a Law Enforcement Investigator with the Medicaid Fraud Control Unit, Office of the Attorney General, State of Florida, and have been so employed for one year. Prior to my employment with the Office of the Attorney General, I was a Police Officer with the Quincy, Florida, Police Department. I have over thirteen years of progressively responsible experience as a sworn law enforcement officer investigating crimes against persons and property. I presently hold a Florida Law Enforcement Officers certificate of compliance issued by the State of Florida Commission of Criminal Justice Standards and Training. Your affiant is currently conducting a criminal investigation of alleged fraudulent Medicaid claims involving a Tallahassee-area Medicaid provider identified as Capital City Area Care (hereinafter “CCAC”). Your affiant has established, through interviews of officials at the Florida Agency for Healthcare Administration (hereinafter “AHCA”), and through reviews of copies of official records maintained by the State of Florida, that CCAC was enrolled with AHCA as a Medicaid provider in August, 2004, under the Home and Community Based Waiver Service - Aged/Disabled Adult Waiver Services Program (hereinafter “A/DA”). The A/DA waiver is a Medicaid program that provides home and community-based services to eligible recipients who, but for the provision of these services, would require nursing facility placement. The purpose of the A/DA Waiver Program is to promote, maintain, and restore the 1 health of eligible elders and adults with disabilities and to minimize the effects of illness and disabilities in order to delay or prevent institutionalization. The A/DA Waiver Program furnishes, among others, adult companion providers, respite providers, homemanager and homemaker providers.1 Your affiant’s investigation has established that CCAC was assigned Medicaid Provider Number 6875131-00. Your affiant’s investigation has also established that the self- reported owner and CEO/COO of CCAC is a black female individual identified as Titilayo I. Dokun, a Nigerian citizen, with a date of birth of October 1, 1963. Predication. Your affiant’s investigation was predicated on a referral to this office from AHCA reporting that “Capital City Area Care billed $117,308.00 for two clients that were not referred by either the Senior Center or the clients' county offices of the Council on Aging as required by Medicaid policy.” Additionally, AHCA reported that “on August 25, 2006, the provider [CCAC] was instructed to stop using Medicaid provider number 6875131- 00 to bill for any service in the Aged & Disabled Adult Waiver program; however the provider continues to bill Medicaid using this number... and billed for services in excess of the contracted amount.” 1 Aged and Disabled Adult Waiver Services Coverage Limitations Handbook. 2 On November 6, 2006, your affiant interviewed Jennifer Jones, Medicaid Waiver Specialist, employed by the Area Agency on Aging of North Florida, (hereinafter “AAANF”). Jones stated that her agency handles clients/individuals age 60 and above, and that some of the clients are physically disabled. Jones stated the clients have to be enrolled in the Florida Medicaid Waiver Program to receive services such as homemaking and companion care. During your affiant’s investigation it was discovered that alleged fraudulent Medicaid claims were filed for not only two - but at least three clients. Jones stated she was monitoring the clients’ database and discovered that three Medicaid clients were receiving services from CCAC, but that the three clients were not enrolled in the Medicaid Waiver Program and CCAC did not have authorization to provide services and to bill Medicaid for those services. Jones stated that in May 2006, she contacted the Gadsden County Senior Citizens Center, (hereinafter “GCSC”) to see if the clients were enrolled in the Medicaid Waiver Program, and subsequently received information that the three clients in question were not in the Medicaid Waiver Program. Jones stated that she thereafter contacted Titilano Dokun, the registered agent/owner of CCAC, and told her the three named recipients were not in the Medicaid Waiver Program, and that Dokun could not provide or bill for those services. Jones subsequently stated to your affiant that in December 2005, Florida Department of Children and Families referred Medicaid recipient “MW”2 to Capital City Area Care for Home and Community Based Waiver Services. Jones stated that once a referral is made, the Medicaid provider (in this case, CCAC) is given instructions by DCF 2 The Medicaid recipient is referred to by the initials “MW” to protect confidentiality and maintain protected health information. 3 regarding the requirements of the services and the requirements of the Medicaid Waiver Program. On November 16, 2006, your affiant interviewed Marian Sheals, Adult Physically Disabled Specialist at DCF, who confirmed that DCF referred recipient “MW” to CCAC for waiver services, and that she, Marian Sheals, knew Titilayo Dokun. Sheals stated, in substance, that the only clients that DCF would refer to CCAC would be authorized Medicaid Waiver recipients. Sheals’ information and knowledge was positive that Titilayo Dokun knew the requirements of the waiver program, specifically that no Medicaid client could receive such services unless the client was authorized to be enrolled in the Medicaid Home and Community Based Waiver program. In a May, 2006, conversation with Dokun, Dokun acknowledged to Sheals that she (Dokun) had been providing waiver services to recipient “EG”3 and that “EG” was receiving these services based on an (unidentified) physician’s referral, not on the required enrollment in the Medicaid waiver program. Theft, Count I On November 14, 2006, your affiant interviewed Medicaid recipient “AF”.4 “AF” is a disabled adult under age 60, and is not enrolled in the Home and Community Based Waiver Service Program for disabled adults. “AF” stated to your affiant that on or about November, 2005, an individual he identified as “Titi Dokun” appeared at his/her 3 The Medicaid recipient is referred to by the initials “EG” to protect confidentiality and maintain protected health information. 4 The Medicaid recipient is referred to by the initials “AF” to protect confidentiality and maintain protected health information. 4 residence and stated to him/her that she (Dokun) was there to provide services to him/her, and that she would be sending other persons to his/her residence to assist, or words to that effect. Shortly thereafter, an employee identified by “AF” as Jacqueline Bryant/Byrd came to the residence of “AF” and began to provide services, such as cleaning and preparing meals. According to “AF”, Bryant/Byrd provided these services to “AF” from approximately 8 AM to 9 AM, and again from 6 PM to 7PM on a daily basis, seven days a week. “AF” stated to your affiant that on several occasions, at the end of a month, Bryant/Byrd would ask “AF” to sign a form stating that all services were provided. “AF” stated that on one or more occasions, he/she refused to sign these forms because he/she stated to Bryant/Byrd that some of the services that were listed on the form were not provided to “AF”, such as companionship when only cooking was provided. “AF” stated to your affiant that such services were provided to “AF” no more than two hours per day, and that these services were provided by Bryant/Byrd, and not by “Titi Dokun.” Your affiant’s investigation has established that Medicaid reimbursement funds are electronically deposited into two accounts at the Premier Bank in Tallahassee using the account name “Capital City Area Care.” Your affiant’s examination of records pertaining to these accounts shows that the only authorized signer for these accounts is “Titilayo Idowu Dokun.” Further, your affiant’s examination of summary claims data paid by the Florida Medicaid program to CCAC for services provided to “AF” show that an aggregate amount of $79,000.00 was paid to CCAC based on claims for Home and Community 5 Based Waiver services to “AF”. The paid amount was based on claims for services to “AF” during the period December, 2005, to August, 2006, on a 24-hour per day, 7-days a week basis. Your affiant’s investigation has also established that Jacqueline (nee Bryant) Byrd is not a Medicaid provider, and that “AF” was not approved by the State of Florida to receive the services billed by CCAC. Theft, Count II. Further, on November 14, 2006, your affiant interviewed “EG”, a disabled Medicaid recipient under the age of 60. “EG” stated to your affiant that home care services (including respite and companion services) were provided during the period October 2005 to July 2006 by multiple employees of CCAC, including a Beatrice Reed, and a “Tamika” LNU, but not by “Titi”, who only came to the residence of “EG” on one occasion to advise “EG” that such services were forthcoming. “EG” stated that these home care services were not provided by CCAC to him/her on a 24-hour a day, 7-day a week basis, but were provided from 10AM to 6 PM throughout the week. Your affiant’s investigation established that “EG” was not authorized by the State of Florida to receive the services billed to the Florida Medicaid Program by CCAC, and that the fraudulent billing for these services amounted to approximately $40,232.50. Theft, Count 3: On November 14, 2006, your affiant interviewed “CC”5, a Medicaid recipient under the age of 60. “CC” stated to your affiant, in substance, that a “Ms. T” from Capital City Area Care signed him/her up for services, but that a Regina Harrison 5 The Medicaid recipient is referred to by the initials “CC” to protect confidentiality and maintain protected health information.