A Prineville, Oregon woman was sentenced to federal prison for using stolen identities to submit fraudulent healthcare claims resulting in over $1.5 million in misappropriated funds from the Oregon Health Authority (OHA) Medicaid Program and filing false tax returns that failed to report earnings she received. Darla K. Byus, 55, was sentenced to 48 months in federal prison and three years’ supervised release. She was also ordered to pay $2,033,315 in restitution to OHA and the IRS. According to court documents, from January 2019 to August 2021, Byus used her company, Choices Recover Services (CRS), to overbill the OHA Medicaid Program for substance abuse counseling services and to submit fraudulent reimbursement claims using the stolen identities of Medicaid recipients.
As an OHA Medicaid Provider for drug and alcohol related counseling services, CRS had access to a provider portal through the Medicaid Management Information System. Byus exploited this access to privileged information to determine a victim’s Medicaid eligibility. She then used their personally identifiable information to submit claims without the victim’s knowledge or authorization. Byus used the stolen identities more than 45 victims, at least a third of which were identified by searching jail roster websites for recent drug or alcohol related offenses. Using CRS, Byus submitted over $3 million in false claims to the OHA Medicaid Program and received over $1.5 million in fraudulent proceeds. She used the misappropriated funds to purchase multiple properties in Oregon and to gamble. In addition, Byus knowingly filed false tax returns for herself and CRS, failing to pay approximately $450,438 in taxes.
