An Alton woman has pleaded guilty to a one-count indictment charging she engaged in a scheme to commit health care fraud. 46-year-old Roslyn R. James and 14 others from throughout southern Illinois were charged in 12 separate indictments by a Federal Grand Jury in July with the offense of Health Care Program Fraud. James admitted she falsely billed the Medicaid Waiver Program over $50,000 for services that were supposed to have been provided to her son.
The Medicaid Waiver Program is designed to allow people to stay in their homes instead of entering a nursing home. This was the second wave of indictments arising out of the abuse of that program. Several investigations uncovered services being billed, but not performed, due to the personal assistant being in jail or out of town. Others revealed that some personal assistants and beneficiaries were receiving the Medicaid payments for services not rendered and simply splitting the paychecks. James faces up to ten years in prison, a $250,000 fine and up to three years of supervised release when she is sentenced January 10, 2014.