CHARLESTON – The state Department of Health and Human Resources says a Georgia-based company tried to defraud the state’s Medicaid program for almost $10 million.
The DHHR filed its complaint against Elab Solutions Corporation, Marty Smith, Ann Smith, Robert Lurie and Christy Lurie in Kanawha Circuit Court.
The DHHR’s Bureau for Medical Services is the state agency responsible for administering the state’s Medicaid program. Marty Smith was Elab’s CEO, Ann Smith was COO, Robert Lurie was president and Christy Lurie was CFO.
According to the complaint, the defendants willfully made, attempted to make or caused to be made certain claims for benefits, payments or allowances under DHHR medical programs that were false, fictitious or fraudulent. When the defendants received those payments, the DHHR says that constituted fraud.
The DHHR says the defendants submitted such claims from January 1, 2013, to March 31, 2018. It says the claims included improper ordering/referring provider information, claims for improper confirmation testing, claims for improper reflex testing, claims for improper validity testing, claims for improper duplicate testing and claims for services that were ineligible to be paid.
It says the fraudulent claims submitted to the state Medicaid program by the defendants totaled $9,594,314.25.
Because the defendants are liable for the $9.5 million in overpayments, the DHHR says state code allows it to recover damages equal to three times the amount. So, it says the defendants owe treble damages of $28,782,942.80 as well as attorney fees, court costs, investigative fees and other fees.
The DHHR is being represented by Assistant Attorney General Michael Myers with the Medicaid Fraud Control Unit. The case has been assigned to Circuit Judge Carrie Webster.
Kanawha Circuit Court case number 23-C-732