Columbus woman sentenced to 1 year in prison for Medicaid fraud - WTVM.com-Columbus, GA News Weather & Sports

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Columbus woman sentenced to 1 year in prison for Medicaid fraud

Della Upshaw at the time of her 2013 arrest. (Source: Muscogee County Jail) Della Upshaw at the time of her 2013 arrest. (Source: Muscogee County Jail)

COLUMBUS, GA (WTVM) - A Columbus woman has been sentenced to one year in jail, plus additional terms following a guilty plea of defrauding the Medicaid program.

Della Upshaw pled guilty to one count of Medicaid fraud in Muscogee County Superior Court on June 23.

Upshaw was sentenced to one year in prison, followed by nine years' probation and ordered to pay $98,344.15 in restitution.

Upshaw was arrested in October 2013. At the time, she was the owner of Senior Care of Columbus and Reaching out Healthcare.

The companies were enrolled in the Community Care Service Program, a Medicaid program administered by the Georgia Department of Community Health, for senior citizens in need of assistance, including in-home personal care and day health services.

The charges indicated that Upshaw submitted numerous fraudulent claims for and was reimbursed for services that were not provided to patients from 2009 to 2011. Those claim submissions began an investigation after the discovery of a high percentage of claims for reimbursement to Georgia Medicaid without documentation, a release from the Georgia Department of Law.

The investigation revealed that in many instances, Upshaw billed Medicaid on days when patients received no services at all. She also billed for patients who had been discharged.

"Ms. Upshaw's contract with Georgia Medicaid entrusted her to care for vulnerable senior citizens in need of in-home assistance," said Attorney General Sam Olens. "Ms. Upshaw violated that contract and robbed Georgia Medicaid by submitting bogus claims for treatment that was never provided to patients. She will now pay for her actions with a prison sentence. I applaud Judge Mullins for treating the crime of Medicaid fraud with the seriousness it deserves."

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