CONVICTED: Man accused in "funeral expenses" Medicaid program scheme

MADISON (WITI) — Attorney General J.B. Van Hollen announced that a Milwaukee man has been convicted and sentenced on charges of a scheme to defraud the Wisconsin Medicaid program by false claims for funeral expenses.

Douglas Patton appeared in Milwaukee County Circuit Court and entered pleas of no contest to one count of Medicaid fraud, one count of theft, and one count of theft by fraud.

Judge Dennis Moroney imposed six months in the House of Corrections and stayed the sentence, placing Patton on probation for two years with conditions including a fine of $5,000, restitution in the amount of $3,510.44, and no participation in any Medicaid program.

According to the criminal complaint, Patton was engaged in a scheme to defraud the Wisconsin Medicaid program by submitting a false claim for payment under the Wisconsin Funeral and Cemetery Aids Program (WFCAP) and forging documents to support his false claim.

WFCAP provides Medicaid funding for certain eligible recipients’ funeral, burial, and cemetery expenses.

The Milwaukee County Department of Health & Human Services (MDHHS) maintains oversight and administers WFCAP claims in that county.

Medicaid is a healthcare program for the needy and people with disabilities jointly funded by the state and federal governments.

Patton submitted an application for payment of a claim to MDHHS that was both falsely inflated and contained a forged signature.

An investigation found that the next-of-kin whom Patton claimed signed the application form on behalf of the deceased that purportedly supported his claim for services did not, in fact, sign the application form.

Patton applied for – and was paid – $1,500 for the false claim.

Patton further engaged in the scheme to defraud by falsely claiming to have performed funeral services and selling burial goods that were not provided.

The investigation showed that Patton charged for funeral and burial services, including embalming, dressing/casketing, facilities and equipment, visitation, and a casket, when the deceased was cremated – not buried – and no visitation or wake was held.

The next-of-kin whom Patton claimed signed the Statement of Funeral Goods and Services Selected supporting his claim for services did not, in fact, sign the statement.

Patton was paid $2,010.44 for that false claim.

The case was investigated and prosecuted by the Medicaid Fraud Control and Elder Abuse Unit of the Wisconsin Department of Justice.