Thursday, June 13, 2013

Lori Jo Mueller Sentenced For Defrauding A Home Health Care Company And Medica

MINNEAPOLIS—Earlier today in federal court, an Apple Valley woman was sentenced for defrauding both her employer and Medica. United States District Court Judge David S. Doty sentenced Lori Jo Mueller, age 48, to 51 months on one count of wire fraud and one count of health care fraud in connection to the crime. Mueller was charged on January 9, 2013, and pleaded guilty on February 4, 2013. In her plea agreement, Mueller admitted that from June of 2006 through June of 2012, she embezzled approximately $840,000 from Edelweiss Home Health Care, using the funds for her personal use.

Mueller began working for Edelweiss, which is located in Maple Grove, in 2002, and she was ultimately promoted to the position of vice president of operations. In that capacity, she was responsible for the review and payment of corporate invoices, bookkeeping, and other financial matters. Mueller admitted using her access to the corporate checking account to issue payments to herself. She also concealed her actions from the company owners and made misrepresentations concerning the company’s financial state.

In addition, from March of 2010 through June of 2012, Mueller defrauded Medica, a non-profit corporation that provides health insurance products to individuals and families. She administered claims submitted to various insurers seeking reimbursement for services provided by Edelweiss nursing staff. In some instances, Mueller double-billed by allowing claims for the same services to multiple insurance providers. For example, Mueller allowed both Minnesota Medicaid and Medica to be billed for identical services provided to one client. The particular double-billing resulted in a double-payment to Edelweiss with Medicaid being the proper payer and Medica being the overpayer. As a result of this criminal behavior, Mueller defrauded Medica of over $600,000.

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