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Court says Lyman duo defrauded Medicaid, must repay

Oct 29, 2013 - The Associated Press

CHEYENNE -- A federal judge Monday ordered a Lyman couple who pleaded guilty to defrauding the Wyoming Medicaid system to pay just over $35,000 in restitution.

U.S. District Judge Alan B. Johnson also sentenced Harold Busskohl, 42, and Amy Busskohl, 39, to three years of supervised probation.

The Busskohls pleaded guilty in August to one count each of health care fraud. They were charged with falsely billing for services for developmentally disabled children from 2008 through late 2010.

Prosecutor Christine Stickley told Johnson on Monday that problems with the Busskohls' billing practices came to light when parents complained that money set aside for their children's care was reported spent when they hadn't received the care.

Stickley and state health care officials said that in some instances the Busskohls billed the Medicaid system for providing respite services when they had not. That involves caring for disabled children to give their parents or other caretakers a break.

"They knowingly defrauded Medicaid," Stickley said. "It's not that they didn't keep records so they didn't know."

Judge Johnson said he hopes the state Medicaid system sees the case as a wake-up call in terms of how it undertakes annual reviews of service providers.

Johnson noted the program involved money that was supposed to go to benefit children who can't speak for or care for themselves.

During testimony, Sharon Kuster of the Medicaid Fraud Control Unit of the Wyoming Attorney General's Office said that investigators found very little documentation to substantiate the couple's billings. She said the system allocates a certain amount of time, broken down into 15-minute billing units, for respite care for each child.

"A lot of parents were very upset that the units that were allowed for their child were being paid for without being provided," Kuster said.

Harold Busskohl testified that he didn't worry about documenting the time he spent providing care to children beyond sending in his monthly bills to Medicaid.

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