Opinion ID: 2506955
Heading Depth: 1
Heading Rank: 5

Heading: Assistant's Medicaid Benefits

Text: During their initial consultation meeting on June 4, 2005, Assistant testified she told Respondent her income with the local school district qualified her for Medicaid, and that she needed to maintain that insurance for herself and her two children. Respondent denies they discussed Medicaid at this meeting. Respondent did not provide Assistant health insurance benefits because the premium quotations Respondent received were too expensive. Assistant testified Respondent knew it was important for her to remain a part-time employee so she could qualify for Medicaid benefits. From June 7, 2005 until January 31, 2006, Respondent reported Assistant's income using a 1099 form. [1] In December, 2005, Assistant began working full-time for Respondent. Assistant testified she and Respondent discussed that her increased hours and pay could jeopardize her ability to receive Medicaid benefits. She claims Respondent proposed the idea of splitting her income between an IRS 1099-Misc Form and a W-2 form. [2] According to Assistant, Respondent suggested that her assistance with his bankruptcy practice could be reported as 1099 income and her secretarial work could be reported as W-2 income. She testified that during this discussion she relayed her fear of going to jail if DHHS became aware of her actual income, and he told her, at worst, she would have to pay the money back and that she would get a letter stating she was disqualified from ever receiving Medicaid again. Respondent denies all of Assistant's claims that he initiated and assisted her in defrauding DHHS to receive Medicaid benefits. Respondent maintains he paid Assistant in this fashion at her request and he naively assumed she preferred to split her compensation this way for tax purposes. The record indicates that Respondent reported all of Assistant's income to the IRS, and paid all required taxes on her wages. On at least two occasions, Assistant submitted letters understating her income to DHHS for the continued receipt of Medicaid benefits. These letters were written on Respondent's letterhead and purportedly bore his signature, but Assistant admitted she signed Respondent's name to resemble his signature on both letters. Assistant maintains Respondent authorized her to sign his name to the letters and approved the letters before she sent them to DHHS. Respondent, on the other hand, alleges Assistant submitted these letters on her own accord, without his knowledge, and he first learned of the letters from an Attorney General investigator after Assistant left his employment. The first letter was dated December 19, 2005, when Respondent was in Florida attending to matters related to his father's death. Assistant claims that on December 19th, she discussed with Respondent by phone that her verification was expiring soon, and he told her to draft the letter, sign it, and mail it because they did not have the time to wait. She testified she nevertheless held the letter until the next day when he returned, and he again reiterated she should mail it as soon as possible so her Medicaid benefits would not be interrupted. She stated he even made a comment about how close the signature looked to his. Respondent denies all of Assistant's testimony regarding this letter. Assistant printed these letters on letterhead containing only Respondent's name, although the printed letterhead used in the office during Assistant's employment was embossed with her name, as legal assistant. Assistant claims the office kept supplies of both letterheads. Respondent asserts Assistant altered the letterhead to remove her name to prevent any perception she was a full-time employee. On July 30, 2007, two months after Assistant left Respondent's employment, Respondent replied by letter to a DHHS questionnaire, notifying the agency that Assistant may have underreported her income to continue receiving Medicaid benefits. Notably, in early May, Respondent received notice that Assistant planned to file a malpractice suit against him. On August 27, 2007, Respondent made a complaint to the Office of the Attorney General that Assistant engaged in Medicaid fraud. On September 24, 2007, and again on October 9, 2007, Respondent sent letters to the Attorney General's investigator detailing the amount he paid Assistant over the course of her employment, and denying that he had any knowledge of the renewal letters sent to DHHS. Authorities arrested Assistant for Medicaid fraud and detained her on October 19, 2007. She acknowledged wrongdoing and entered an agreement for pre-trial intervention.