A Milwaukee woman is facing felony charges for allegedly defrauding Wisconsin Medicaid of over $2 million.
Debbie Long, 44, owned Pinnacle Home Health Care LLC, a company that offered βpersonal care servicesβ to members of Medicaid, according to a criminal complaint filed Tuesday. In a statement Thursday, Longβs attorney said his client will fight the charges, saying she is not guilty.
The felony charges are focused on Longβs operations from 2017 to 2022.
βThe State alleges that she defrauded Wisconsin Medicaid of almost $2.2 million by billing for personal care services which did not take place,β the complaint said.
The complaint said she also βfraudulently obtained a $219,072 loan from the Paycheck Protection Program by inflating the size of Pinnacleβs workforce and payroll expenses.β
βLastly, the State alleges that Long used the proceeds from her unlawful activities to purchase a restaurant, a car, and a car wash,β the complaint said. βAs for the purchase of the car and car wash, Long helped funnel her ill-gotten gains through several shell companies in a series of transactions designed to conceal the origin of the funds.β
Prosecutors allege she used a variety of methods to defraud the stateβs Medicaid system, including billing for personal care services that could not have happened.
βIn total, Pinnacle was paid more than $1.57 million in connection with claims for personal care services that were either impossible or improbable,β the complaint said.
She also allegedly billed for services that were never rendered, billed for services in higher amounts and billed for travel expenses that were βnever incurred.β
Prosecutors also allege she defrauded the Paycheck Protection Program, a federal program that was created during the COVID-19 pandemic. The complaint said Long submitted a fraudulent application to that program in May 2020.
In her application, Long said Pinnacle Home Health Care, LLC, had 120 employees and a monthly payroll that averaged nearly $90,000, according to the complaint. However, that information was βdirectly contradicted by the information Pinnacle provided to the Wisconsin Department of Workforce Development (DWD) for the same timeframe,β the complaint said.
Long allegedly used the funds from the PPP loan and from her Medicaid reimbursements to buy Kittβs Frozen Custard, a Milwaukee business.
βLong also helped direct money, obtained from her scheme to defraud Wisconsin Medicaid, from Pinnacle through three shell companies and her own bank accounts to fund the purchase of a Mercedes-Benz AMG S63 and an Octopus Car Wash,β the complaint said. βLong, along with her husband, moved the money around through numerous transactions designed to conceal the origin, ownership, and control of the proceeds.β
Long was charged with one count of fraud against a financial institution, one count of theft by fraud, one count of wire fraud against a financial institution, one count of money laundering and another count of money laundering as party to a crime. All of those charges are felonies.
In a statement, William Sulton, Longβs attorney, said the stateβs argument is based on a clerical error and said its calculations ignore the home health care industry practice of using contractors. He said Longβs actions were legitimate business practices.
βThis complaint is a math exercise designed to reach a pre-determined conclusion,β Sulton said. βIf you account for independent contractors and fix the Stateβs own clerical mistakes, the massive fraud allegations evaporate.β
Long will make her initial appearance in court on July 16, according to online records.