In October 2018, Elijah Caldwell was convicted of forgery and larceny and was banned from working with the Medicaid program. Despite this, he continued to provide behavioral health services at Primal Mental and Physical Health in Oakville and billed Medicaid for those services between October 2019 and January 2020. This resulted in a charge of health care fraud against Caldwell.
Caldwell pleaded nolo contendere to the charge, meaning he did not admit guilt but agreed to pay restitution and abide by certain conditions. The investigation by the Medicaid Fraud Control Unit found that Caldwell had submitted false and misleading claims to the Department of Social Services during this time, resulting in a total loss of $50,000 for the program.
In addition to paying restitution, Caldwell is prohibited from acting as a Medicaid provider due to his prior convictions for forgery and larceny. He was previously barred from Medicare, Medicaid, and all federal health care programs for 10 years due to these convictions. As a result of his actions, Caldwell has faced significant consequences both personally and professionally.
The investigation into suspected fraud or abuse in public health care can be reported to the Medicaid Fraud Control Unit at the Chief State’s Attorney’s Office at 860-258-5986. It is important for individuals who witness any suspicious behavior or activity in healthcare settings to come forward so that it can be properly addressed and prevented from happening again in the future.
