Mike Hilgers

Nebraska Attorney General

Summary Judgement in Medicaid Fraud Case

Lincoln--Lancaster County District Judge Lori Maret entered summary judgment in favor of the State of Nebraska against Lawanda Cook, a Medicaid provider, in the amount of $312,759.45. This stemmed from a civil Medicaid fraud investigation.

Cook was a mental health and substance abuse counselor in the Omaha area. The Nebraska State Attorney General’s Medicaid Fraud and Patient Abuse Unit's (MFPAU) investigation found that Cook submitted 1599 claims for payment to Nebraska Medicaid for which no supporting clinical records existed. She was paid a total of $208,506.30 for those claims. Cook admitted that she did not maintain progress notes or clinical records to support the claims, as required by Nebraska Medicaid regulations. The court agreed with the State and found that Lawanda Cook had committed Medicaid fraud.

The State requested damages in the amount of 150% of the claims submitted. The Court granted that request.

The matter was initially reviewed by Magellan Health and the Program Integrity Unit of the Nebraska Division of Medicaid and Long Term Care at DHHS. It was further investigated by MFPAU Chief Auditor J.O Fitzgerald and Chief Investigator Mark Moraczewski. Assistant Attorneys General Vicki Adams and Sallie Dietrich handled the litigation against Cook.