2 Utah health care providers charged with Medicaid fraud

2 Utah health care providers charged with Medicaid fraud

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ST. GEORGE — The former nursing director and the human resources director of Southwest Utah Public Health Department have both been charged with Medicaid fraud.

Todd Alan Stirling, 51, of Washington City, and Russell Amon Hinton, 38, also of Washington City, were each charged in 5th District Court Monday with engaging in a pattern of unlawful activity, a second-degree felony, in addition to being charged under the Utah False Claims Act, a second-degree felony.

From about October 2015 to February 2016, Stirling and Hinton "improperly caused over 1,300 false claims to be submitted to the Utah Department of Health, Targeted Case Management program, for follow-up calls allegedly made to Medicaid recipients," according to charging documents.

Because of those submitted claims, Medicaid funds were given to the Southwest Utah Public Health Department "for services which were wholly or partially false given that they were not provided in compliance with Medicaid policy, were either never provided or were not provided as billed, and/or were not medically necessary," the charges state.

The charges also allege that Stirling was funneling patients to his own private business.

He "established a company by the name of Feel Good Management LLC (a company formed in Delaware) and used this company to hire employees, make contact with Medicaid recipients, submit improper invoices to SWUPHD and cause false claims to be submitted to the Medicaid program," the charges state. “(Stirling) received payments from SWUPHD for the over 1,300 false claims that were paid by Medicaid, as well as for over 3,000 additional claims that (he) submitted to SWUPHD, but which were not paid by Medicaid."

Charging documents also noted that Hinton "benefitted financially from his involvement with this enterprise as he made it possible for his wife, Megan Hinton, to be paid by Feel Good Management and/or as he received payment directly from the company."

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Pat Reavy


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