Home health worker defrauded $631K from Medica

An employee of a home healthcare provider pled guilty to defrauding the company, as well as insurer Medica. Lori Jo Mueller, who pleaded guilty to wire and healthcare fraud, stole about $1.4 million from Edelweiss Home Health Care and Medica, the United States Attorney for the District of Minnesota announced Monday.

In her plea agreement, Mueller admitted she filed claims from 2006 through 2012 to several insurers, including Medica, to receive reimbursement for services provided by Edelweiss nursing staff, sometimes double billing for one service. In one example, Mueller billed both Minnesota Medicaid and Medica for identical services provided to one consumer, which led to both insurers reimbursing Edelweiss. The district attorney's office said Mueller defrauded Medica of $631,000 and Edelweiss from $840,000. Statement