AG Hector Balderas Secures Prison Sentence Of Woman Who Defrauded Medicaid Program Of More Than $445,000

Attorney General Hector Balderas

AG News:

SANTA FE — Attorney General Hector Balderas announced Monday that the Office of the Attorney General has secured a prison sentence for Lolita Begay-Yazzie as a result of her guilty plea to one count of fraud in excess of $20,000, a second degree felony, and one count of Medicaid Fraud for Failure to Retain Documents, a fourth degree felony.

Begay-Yazzie defrauded New Mexico’s Medicaid program of more than $445,000.

The court sentenced Begay-Yazzie to five-and-one-half years in the Department of Corrections, suspending three years, meaning Begay-Yazzie will serve a period of two-and-one-half years in prison.

She also will be required to pay full restitution in the amount of $445,352 and will be barred from serving as a provider under Medicare, Medicaid or any other state or federal health care program until she has been reinstated by the Office of the Inspector General.

“Medicaid ensures that almost half of all New Mexicans have access to healthcare, and we must do all we can to protect these resources that are so vital to our families,” Balderas said. “We will continue to hold anyone who tries to steal these critical healthcare resources accountable.” 

Begay-Yazzie billed New Mexico Medicaid as if her employees were providing care services in excess of 24 hours in a day. Begay-Yazzie also overbilled Medicaid for more services than each patient required. Begay-Yazzie made withdrawals at ATMs in casinos in excess of $185,000.00 from the personal care agency account. 

This case was investigated and prosecuted by the Office of the Attorney General’s Medicaid Fraud Control Unit (MFCU). MFCU receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award totaling $3,200,478 for Federal fiscal year (FY) 2019-20, of which $2,400,360 is federally funded. The remaining 25 percent of the approved grant, totaling $800,118 for FY 2019-20, is funded by the State of New Mexico.