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Colorado Springs man sentenced to eight years’ probation for illegally billing Medicaid for patients with developmental disabilities

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Sunday, December 22, 2024

Colorado Springs man sentenced to eight years’ probation for illegally billing Medicaid for patients with developmental disabilities

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Phil Weiser | Phil Weiser Official Photo

A Colorado Springs man who pled guilty to felony Medicaid fraud in October was sentenced today to eight years of probation, according to Attorney General Phil Weiser. Gulong Craft, 57, fraudulently acquired $122,441 through falsified medical billing between 2020 and 2023. Craft was also ordered to pay the full amount as restitution.

Last year, Medicaid fraud investigators with the Colorado Department of Law received a case referral related to Craft from the Colorado Department of Health Care Policy and Financing, or HCPF, which administers the state’s Medicaid program. HCPF made the attorney general’s office aware of illegal Medicaid billing by Craft’s company, Craft Care, LLC. The company was enrolled with HCPF to provide care for Medicaid patients who have intellectual or developmental disabilities.

Further investigation found the company had little to no footprint online and neither Craft nor his spouse claimed any wages from the company, and a deeper inspection of Craft’s billing claims showed a suspicious number of denied claims. Because these denied claims continued for years, investigators found this was likely due to intentional fraud, rather than unintentional errors.

A thorough analysis of billing claims made by Craft, along with interviews with caretakers for the Medicaid clients in question, Craft’s own family members, and Craft himself, found that he billed for services long after he stopped providing care for the clients. In one case, for years. Craft also failed to keep records as required under his agreement with HCPF.

“The biggest victims of Medicaid fraud are usually low-income patients who lean on Medicaid for critical health care services,” Weiser said. “In this case, the defendant’s crimes exploited people with intellectual and developmental disabilities. We will remain vigilant in our commitment to protecting Medicaid patients and taxpayers, holding providers who break the law accountable, and recovering fraudulent payments.”

The Colorado Medicaid Fraud Control Unit receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award totaling $3,858,544.00 for Federal Fiscal Year (FY) 2025. The remaining 25 percent, totaling $1,286,181.00 for FY 2025, is funded by the State of Colorado.

Craft’s case was filed in El Paso County District Court, case number 2024CR1799.

Coloradans who suspect or have direct knowledge of Medicaid fraud, or any other type of fraud or scam, are encouraged to file a complaint with the attorney general at StopFraudColorado.gov.

Original source can be found here.

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