TRI-STATE CLINIC TRIO PLEAD NOT GUILTY

Pretrial hearings set for Dec. 9

LOUISA,Ky. — A Louisa medical practice and three of its providers who were recently indicted by a Lawrence County grand jury via an investigation by the Kentucky Attorney General’s Office on charges of Medicaid fraud and forgery of prescriptions, appeared in court Tuesday morning for their plea arraignments.

Dr. Alfred Baldera, 63, Janice Gauze, 47, and Kevin Gauze, 47, all entered not guilty pleas Tuesday morning before a Lawrence County judge.

Baldera is charged with four Class D felonies including two counts of Medicaid fraud, one count of forgery of a prescription and two counts related to unlawful prescribing of controlled substances. If convicted, he could be facing up to 20 years in prison.

Kevin Gauze also faces up to 20 years, charged with five Class D felonies, including two counts of Medicaid fraud, one count of forgery of a prescription, two counts related to unlawful prescribing controlled substances and one count related to unauthorized procurement of controlled substances.

Janice Gauze faces up to five years for one Class D felony related to unauthorized procurement of controlled substances.

Added to all of the criminal charges, Tri-State Family Medical Center LLC could get up to $20,000 in fines for two counts of Medicaid fraud and one count of forgery of a prescription.

The pretrial hearings for Dr. Baldera and both of the Gauze’s’ have been set for at 11 A.M., for December 9, 2016.

According to a press release and further interview statements by Attorney General of Kentucky Andy Beshear, the focus of the investigation of Tri-State Family Medical Center started with allegations that between 2010 and 2013, Kevin Gauze and Alfred Baldera fraudulently billed Medicaid for office visits and drug testing where patients were not present.

It is also alleged that during 2016, Kevin Gauze and Dr. Baldera fraudulently billed Medicaid for services utilizing Dr. Baldera as a performing provider when Baldera was not present at the doctor’s office.

Additionally, it is further alleged that Dr. Baldera and Kevin Gauze forged Baldera’s signature on prescriptions for controlled substances for himself.

Also, it is alleged that Janice Gauze presented prescriptions for controlled substances which were not authorized.

“My office will pursue any and every provider who attemps to steal from the Medicaid Program,” according to Attorney General, Andy Beshear. He further stated, “Medicaid is a vital service that our state can afford and must support. My office is committed to protecting Kentucky families and seniors from anyone who would defraud such a critical program.”

The fraudulent criminal case involving Baldera, the Gauze’s and Tri-State Family Medical Center was investigated by the Office of Medicaid Fraud and Abuse of the Kentucky Attorney General’s Office, with assistance from the Appalachia HIDTA Diversion Task Force, and the Cabinet for Health and Family Service’s Office of the Inspector General, Drug Enforcement and Professional Practices Branch.