Colorado medical biller charged with fraud involving $1.2M in Medicaid claims

(The Center Square) – A medical biller was charged with fraud and theft involving $1.2 million in claims to Colorado’s Medicaid health insurance program.

Natasha Sawyer, 44, of Denver, was charged by Colorado Democratic Attorney General Phil Weiser with felony counts of Medicaid fraud and waste-false claims of $1 million or more and cybercrime theft of $1 million or more.

The six-page complaint filed in Denver District Court states Sawyer committed the alleged crimes between May 2020 and March 2021. Sawyer worked as a Medicaid biller for Element Medical Supply, a durable medical equipment company, according to a media release from Weiser’s office.

An investigation found Sawyer allegedly submitted false claims for enternal nutrition formula, a specialized liquid administered directly into the gastrointestinal tract. It provides nutrition to patients who are unable to consume enough food orally.

The investigation found approximately 5% of the formula billed to Medicaid was delivered to patients. The investigation linked a username and IP addresses used to submit the claims to Sawyer’s location and identity.

“Not only does taking advantage of the state’s Medicaid system harm all of us as taxpayers, it harms the entire health care system by threatening to erode trust in providers,” Weiser said in a statement. “We will not hesitate to investigate and prosecute those who exploit Medicaid and the patients the system serves.”

Colorado’s Medicaid Fraud Control Unit, which led the investigation and operates in the Colorado Department of Law, receives 75% of its funding from the U.S. Department of Health and Human Services through a $3.8 million grant in federal fiscal year 2024. The federal department oversees the Centers for Medicare and Medicaid Services. The remaining 25% or $1.2 million of funding for Colorado’s Medicaid Fraud Control Unit is funded by the state during the federal fiscal year.