Michigan Takes Part in Department of Justice’s 2025 National Health Care Fraud Takedown

LANSING – Today, the U.S. Department of Justice announced criminal charges against 324 defendants nationwide, involving 12 State Attorneys General’s Offices across the United States, in connection to schemes to defraud Medicaid, Medicare, and TRICARE as part of the Department’s National Health Care Fraud Takedown. Two Michigan cases were announced as a part of the campaign, Attorney General Dana Nessel announced.

“Fraud affects everyone - the recipients of care, the taxpayers who pay for it, and the overwhelming majority of providers who conscientiously provide quality care,” said Nessel. “The answer to protecting these vital services is not to cut off access or to drastically slash funding that hundreds of thousands of Michiganders rely on, but to root out fraud where it’s happening and hold bad actors accountable. The States’ Medicaid Fraud Control Units are the most important tool we have to that end.”

The National Health Care Fraud Takedown Campaign is a nationwide law enforcement action targeting defendants for their alleged participation in health care fraud and illegal drug diversion schemes that involved the submission of over $14.6 billion in alleged false billings and over 15.6 million pills of illegally diverted controlled substances. The defendants allegedly defrauded programs entrusted for the care of the elderly and disabled, to line their own pockets. In connection with the Takedown, the Government seized over $245 million in cash, luxury vehicles, and other assets.

The two Michigan cases include:

• James Alexander Carthron, 61, of Saginaw, Michigan, was charged with making false claims to Medicaid in connection with a scheme in which Carthron allegedly billed for services he did not render, totaling approximately $11,000.00. As alleged in the complaint, Carthron, a Medicaid enrolled provider, billed Medicaid for 23 telephone evaluation and management visits he claimed to have provided to three beneficiaries that he did not provide.
• Daleena Taree Miller, 42, of Battle Creek, Michigan, was charged with making a false claim to Medicaid and intentionally placing false information on a medical chart, in connection with a scheme in which Miller allegedly caused Medicaid to be billed for services she did not render totaling $8,640.00. As alleged in the complaint, Miller, a Community Living Support worker for a Medicaid beneficiary, worked fewer hours than required and billed to Medicaid, documented false information of what services she provided, and included inaccurate information in the Beneficiary’s medication administration record. 

Both cases are being handled by the Department’s Health Care Fraud Division (HCFD). The HCFD exists to identify, prosecute, and prevent fraudulent activity by doctors, dentists, pharmacists, and other health care providers participating in the Medicaid program. Allegations of misappropriation of patient trust funds and identity theft in resident care facilities are also investigated. Taxpayer dollars provide health care to indigent patients and other recipients.  

The HCFD also operates the Department’s Sentinel Project, which uses specially trained staff to examine long-term care facilities for evidence of abuse or neglect through unannounced visits. These discrete, but comprehensive, site investigations help investigators determine if additional action is necessary, either through further enforcement actions in conjunction with the state’s Licensing and Regulatory Affairs Agency, or through criminal prosecutions.

If you or someone you know is being abused or neglected in a nursing facility, please file a complaint online through the Michigan Attorney General Patient Abuse Complaint form. For complaints regarding Medicaid Fraud, please use the Michigan Attorney General Medicaid Fraud Complaint form. Alternatively, residents can contact the Michigan Attorney General's Health Care Fraud Hotline at (800) 24-ABUSE (2-2873). The Michigan Health Care Fraud Division receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award totaling $5,703,460.00 for federal fiscal year 2025. The remaining 25 percent, totaling $1,901,152.00, is funded by the State of Michigan.

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