(IDAHO FALLS, ID) — Diana J. Gifford, 28, of Idaho Falls, was sentenced Monday on two felony counts of Medicaid provider fraud, Attorney General Lawrence Wasden said. Seventh District Judge Dane H. Watkins, Jr. sentenced Gifford to two to five years in prison. The court suspended the prison sentence and ordered Gifford to serve 30 days in the county jail and five years probation. Gifford also must pay a $500 fine, perform 100 hours of community service and satisfactorily complete drug court.
The Attorney General’s Medicaid Fraud Control Unit filed a criminal complaint on November 10, 2011, charging Gifford with three counts of Medicaid provider fraud and one count of grand theft. On February 13, 2012, Gifford pleaded guilty to two counts of Medicaid provider fraud. Pursuant to a plea agreement, the state dismissed the remaining charges.
Medicaid paid Gifford, whose son is a Medicaid recipient, to drive him to medical appointments in Salt Lake City. In late 2007, she began billing Medicaid for trips that did not occur. Between September 2007 and May 2010, Gifford fraudulently billed and was paid by Medicaid for 422 fictitious trips between her home in Idaho Falls and medical providers in Salt Lake City. These false billings, for 168,800 miles that were not actually travelled, resulted in a $17,224 loss to Medicaid.
The court ordered Gifford to pay Idaho Medicaid $17,224 in restitution, along with $3,941.23 in pre-judgment interest. Gifford also must pay $317.75 for investigative costs.
“Fraud by Medicaid providers is a serious crime and a theft of the taxpayers’ money,” Attorney General Wasden said. “My office is committed to prosecuting Medicaid fraud, recovering the taxpayers’ money and holding the criminals accountable.”
The Department of Health and Welfare’s Medicaid Program Integrity Unit conducted a preliminary investigation of the case and referred it to the Attorney General’s Medicaid Fraud Control Unit for investigation and prosecution. The Attorney General served as special prosecutor at the request of the Bonneville County Prosecuting Attorney.