Raúl Torrez | Attorney General

AG Balderas Secures Prison Sentence of Former Personal Care Organization Owner Who Defrauded Medicaid Program of Over $445,000

For Immediate Release:
April 12, 2021
Contact: Matt Baca — (505) 270-7148

Santa Fe, NM–Today, Attorney General Hector Balderas announced 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 over
$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 will also 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,” said
Attorney General Balderas. “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.

Raul Torrez

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