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Former Priority Partners employee pleads guilty to Medicaid fraud

Former Priority Partners employee pleads guilty to Medicaid fraud

A former employee of Priority Partners, a Medicaid Managed Care Organization owned by Johns Hopkins HealthCare, pleded guilty to felony Medicaid fraud for altering medical records that caused the Medicaid to improperly pay the company more than $875,000.

Inca Elfriede Schultz, 61, of Cudjoe Key, Fla., was sentenced to five years incarceration by Anne Arundel County Circuit Court Judge Michael Wachs. He suspended all but 18 months of her sentence to be served in home detention.

Wachs put Schultz under supervised probation for three years and ordered that she not be allowed to work with a health care provider in a federally funded health care program for five years.

Reached by phone Friday, Schultz declined comment. Hopkins did not respond immediately to request for comment.

Schultz, a registered nurse, worked as a contracted senior project manager for Priority Partners, reviewing medical records for the company's compliance department.

In May 2014, nurse supervisors in the compliance department noticed that many of the records reviewed by Schultz had been altered.

A review found that between 2011 and 2014 Schultz had electronically accessed 792 medical records and altered either the paper medical record or its electronic version in 52 instances. Schultz worked remotely from her home in Florida and submitted her reviews of medical records electronically.

Schultz' tampering resulted in Medicaid improperly paying $875,279 in incentive payments to Priority Partners.

Priority Partners has returned all of the money.

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