Medicaid Fraud Investigation Leads To Sentence That Includes $646,000 Restitution Payment

(INDIANAPOLIS) – Attorney General Curtis Hill said today that the sentencing of a Fort Wayne woman demonstrates the seriousness with which authorities view the crime of health care fraud in connection with the Medicaid program.

After pleading guilty to health care fraud and aggravated identity theft, Susanne “Suzi” Gawel was sentenced Wednesday to 48 months in prison, one year of supervised release and ordered to pay $646,690.32 in restitution.

Gawel worked as an office manager at a Fort Wayne company that sold durable medical equipment (DME) to clients across northern Indiana. Some of the company’s clients were Medicaid beneficiaries. Through her work, Gawel had access to Medicaid patient information, including patients’ names, addresses, dates of birth, Medicaid ID numbers and treating physician information.

From about January 2015 and continuing to about October 2018, Gawel devised a scheme to defraud Medicaid, according to court documents. During this time period, she submitted over 200 reimbursement claims to Indiana Medicaid for DME, including oximetry devices and pneumatic compressors, which were not provided to Medicaid recipients and/or for which they had no medical necessity and/or for which there was no physician order.

In total, her scheme defrauded Indiana Medicaid of approximately $646,690.32.

“We are committed to exposing waste, fraud and abuse of Medicaid funds and bringing to justice those who have broken the law,” Attorney General Hill said. “I am proud of the investigative work of our Medicaid Fraud Control Unit in this case, and I am grateful as well for the contributions of our federal partners.”

Besides the Office of the Attorney General’s Medicaid Fraud Control Unit, other agencies that worked on this case are the Federal Bureau of Investigation and the U.S. Department of Justice, which prosecuted Gawel.

“My Office is focused on prosecuting fraud cases such as this one,” said United States Attorney Thomas L. Kirsch II. “Defrauding a federally funded health care program like Medicaid cheats all taxpayers. This case demonstrates that when individuals exploit a federally funded program, our law enforcement partners will investigate and my Office will prosecute and hold accountable those responsible.”

FBI Indianapolis Special Agent in Charge Paul Keenan said, “The investigation of health care fraud is a priority for the FBI and this type of illegal conduct will not be tolerated. This sentence not only emphasizes the cooperation between federal, state and local law enforcement agencies to identify and investigate those who engage in this type of crime, but also sends a clear message to those who would exploit federally funded health care programs that they will be held accountable.”

The Indiana Medicaid Fraud Control Unit receives 75% of its funding from the U.S. Department of Health and Human Services under a federal grant. The remaining 25% is funded by the State of Indiana.