FOR IMMEDIATE RELEASE: Thursday, June 11, 2015
CONTACT: Sara Rabern (605) 773-3215
Madison Man Sentenced in Medicaid Fraud Case
PIERRE, S.D. - Attorney General Marty Jackley announced today that Shawn Earl Nills, 42, Madison, was sentenced to serve 5 years in the State Penitentiary for committing Medicaid fraud.
Third Circuit Court Judge Vincent A. Foley suspended the execution of sentence on several conditions. Judge Foley ordered Nills to serve 90 days in county jail, 2 years of probation, and ordered him to pay a total of $27,680.22 in restitution to the State of South Dakota. Nills was also ordered to pay a $750 fine, and pay court costs of $104.00.
“Fraudulent billing of Medicaid services affects those patients that are in financial need of medical assistance the most and is a direct hit on taxpayers,” said Jackley. “In South Dakota we are fortunate that the vast majority of our health care professionals respect our taxpayer’s monies while serving our Medicaid patients.”
Nills pleaded guilty on March 18, 2015, in Lake County Criminal Case #15-22 to Making False Claims, a class 5 felony, pursuant to a plea agreement reached with the State. Nills admitted that he knowingly and intentionally submitted false claims to programs funded by the State of South Dakota, including Medicaid, while he worked as a mental health counselor in Madison. Nills admitted that he knowingly and intentionally prepared numerous progress notes for counseling sessions that did not occur. Nills further admitted that he used these fraudulent progress notes to substantiate false claims that he had submitted between October 3, 2012, and March 28, 2014.
Nills admitted that the value of the false claims is at least $9226.74. The State trebled that amount, as allowed by statute, and Nills paid $27,680.22 in restitution to the State on March 18.
Special Agent in Charge, Gerald T. Roy, HHS/OIG, Kansas City, MO, stated, “Our office will continue to work jointly with our law enforcement partners to bring those to justice who defraud the Medicaid program.”
The case was investigated and prosecuted by the South Dakota Attorney General's Medicaid Fraud Control Unit, with assistance from the South Dakota Department of Social Services, the US Department of Health and Human Services - Office of Inspector General, the Madison Police Department, the Lake County Sheriff's Office, and Nills' former employer, Community Counseling Services. Jackley commends CCS for reporting the case to authorities, and for their continued assistance throughout the case.