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Sheboygan County nurse charged with Medicaid fraud

(WJRT)
Published: Sep. 18, 2020 at 4:44 PM CDT
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SHEBOYGAN COUNTY, Wis. (WBAY) - A woman who worked as a private nurse in Sheboygan County is charged with three counts of medical assistance fraud. Lori Kleinhans, 62, of Adell, faces up to 18 years in prison if she’s found guilty.

The Wisconsin Department of Justice (DOJ) Medicaid Fraud Control Unit investigated the case. According to the criminal complaint:

A child Kleinhans was supposed to be providing care for in 2018 was repeatedly missing medical appointments. It was brought to the attention of authorities, and a surveillance camera was installed to watch the house. Kleinhans was only seen at the house on five days between July 19 and August 7, visiting once or twice a day, with visits lasting as little as 5 minutes and no longer than 41 minutes. Kleinhans was consistently billing Medicaid for 60 hours a week and reporting she was giving the child constant supervision.

Investigators questioned the child’s mother, who insisted Kleinhans only missed one day of work and always took the child to weekly oncology appointments. She said any claims Kleinhans wasn’t doing the work were false. Records showed the child missed 25 appointments at Children’s Hospital of Milwaukee while Kleinhans worked for the family. The mother denied receiving any money in exchange for Kleinhans not taking care of the child.

The criminal complaint further claims Kleinhans billed Medicaid for working 12 hours of work per day for three days in October, 2017, when she was a plaintiff in a jury trial. Online court records confirmed she was present every day of the trial.

And investigators learned Kleinhans was receiving Medicaid benefits herself through BadgerCare Plus. In 2018, she declared no one in her home had a job or was self-employed, even while she was working as a private nurse and billing Medicaid.

The DOJ filed the charges in Dane County Circuit Court.

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