Criminal Justice Update
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Criminal Justice Update

Q&A: Health Care Fraud Section chief emphasizes collaboration

Keesha Mitchell’s staff has expanded by 12 in the past two years to better assist law enforcement and prosecutors statewide.

On working with local partners
We have our highest-ever number of open cases right now, in large part because of outreach to local law enforcement and prosecutors as well as to our federal and state partners. We want to stress that we’re available for local law enforcement agencies. So if you need assistance with a case involving patient neglect or abuse, financial exploitation, or drug diversion in a care facility, call us. We’ll be involved to the extent that you want us to be involved. Likewise, we really work to partner with the county prosecutors’ offices. They’re the ones who are most knowledgeable about the care facilities in their county and how best to bring cases in their courts. We try to work jointly and think about the best way to bring these cases. And sometimes it’s who has the most time and investigative resources to bring to bear in a particular case.
On abuse and neglect cases
We have statewide jurisdiction to investigate patient abuse and neglect. Most of our referrals come from the Ohio Department of Health, because care facilities are mandated to report abuse or neglect to the Department of Health. If we think a referral rises to the level of a criminal case, we investigate. In those instances, we send a letter to the local law enforcement agency to let them know that we’ll be in their jurisdiction investigating or, if they are already looking into the matter, that we can work alongside them. If they don’t need our help, we close our case.
On resources available for local investigations
We’ve added to our surveillance capabilities, and that’s an important tool we share with prosecutors and law enforcement agencies. For instance, in theft cases within care facilities, we’ve had very good success putting in cameras and finding the perpetrator. Using surveillance video, we are able to get thieves who prey on the elderly to admit to many unsolved thefts. We also use surveillance cameras in home health cases, situations in which you have aides billing the state for, say, 18 hours of services a day when they’re only providing two. And in care facilities, we’ve been able to get evidence of aides and nurses diverting patient medications.
On pursuing unethical doctors
We have statewide jurisdiction to investigate and prosecute Medicaid fraud. If officers think there are drug buys going on in a physician’s parking lot, for instance, that’s a situation where we don’t have jurisdiction over Medicaid recipient fraud, but we do have jurisdiction over Medicaid provider fraud. So if doctors are writing prescriptions that are medically unnecessary and the prescriptions are getting filled with a Medicaid card, we have jurisdiction. And often, the best way to prosecute unethical physicians, instead of having to prove aggravated trafficking, is to prove false billing to the Medicaid program. We can certainly partner in those cases.
On workers’ compensation cases
With the workers’ compensation unit, the investigations are done by Bureau of Workers’ Compensation agents, and the prosecution is handled by our assistant attorneys general. At times we refer cases to county prosecutors when we have employer fraud.
The Keesha Mitchell File

Current role: Mitchell has been chief of the Attorney General’s Health Care Fraud Section since mid-2010.
Previous jobs: She was the section’s assistant chief for seven years and, before that, served as an assistant attorney general in its Workers’ Compensation Unit. Prior to joining the AG’s office, she was an attorney with the Franklin County Public Defender’s Office.
Education: She holds a bachelor’s degree from Mount Holyoke College in South Hadley, Mass., where she majored in political science, and a law degree from The Ohio State University.
Family: Her family includes husband Michael, a fourth-grade teacher for Columbus City Schools, and three children, ages 16, 15, and 10.
For fun: She enjoys reading, exercise, and watching her children compete in basketball, golf, cross country, and baseball.