SEQUIM — A man who told state investigators that he wanted to be paid to take care of his wife with funds from state and federal health care programs has been sentenced to 30 days in jail for bilking $111,705 from the programs over nearly four years.
Jeffrey R. Edgington, 54, of Sequim was sentenced in Thurston County Superior Court to 30 days on Medicaid-fraud-related charges after pleading guilty to four counts of theft and four counts of Medicaid false claim.
He used the funds to pay for “mortgage/rent, utilities, cable, and personal expenses including [Seattle Seahawks football game] tickets and newspaper subscriptions,” according to court records.
The couple’s daughter, Crystal L. Edgington, 28, of Port Angeles also was sentenced to 30 days after pleading guilty to four counts of theft and two counts of Medicaid false statement.
The sentencings were carried out earlier this month.
The Edgingtons also must pay the $111,705 they illegally billed Medicaid plus $800 in fines and court fees.
Crystal Edgington had signed up to take care of her mother, a client of the state Department of Social and Health Services’ Community Options Program Entry System, which funds in-home care for the poor, at her father’s home at 105 Olympus Court in Sequim.
She billed Medicaid from May 2008 to January 2012 for services she did not provide, while her father called in the hours on the program’s automated system from the home he shared with his wife, according to the state Attorney General’s Office.
“Jeffrey Edgington was providing basically all the care, but he was not permitted by law to be the paid caregiver because he’s a spouse,” said Carrie Bashaw, senior counsel and assistant state attorney general in the agency’s Medical Fraud Control Unit.
“She was working and would give the money to Jeff for this four-year period,” Bashaw said.
The Edgingtons’ intent was not to have “strange care providers” taking care of the woman, she said.
“They were trying to keep the mother at home . . . and have people she knew and was comfortable with providing her care, which was her husband.”
Parents also cannot be paid caregivers to their minor children, Bashaw said.
“Society and policy makers have chosen to recognize that when you are married and make a vow to each other, and when you are parent and have a legal obligation to children, that that does not necessarily translate to receiving money to do the thing that you have a legal obligation to provide.”
The case was adjudicated in Thurston County because the state Treasurer’s Office in Olympia disburses the funds, Bashaw said.
“For these kinds of cases, it’s a big one, partly because it went on over a four-year period of time,” she said.
Two discoveries helped tip off the fraud unit that the case was worth investigating, according to the Attorney General’s Office.
The fraud control unit discovered that Crystal Edgington was working another job while also taking care of her mother.
Then an investigator found out that she allegedly was taking care of her mother even though the mother was at Swedish Medical Center in Seattle from June 7, 2011, to July 28, 2011, Bashaw said.
Jeffrey Edgington had no job other than taking care of his wife, Bashaw said.
The state Attorney General’s Office did not release the woman’s name, identifying her only as “K.E.” in court documents.
Bashaw would not comment on where the woman is being cared for or her medical condition.
The woman “was totally dependent on a caregiver for locomotion outside of her room, housework, medication management, meal prep and other tasks,” Medicaid Fraud Control Unit Investigator Nancy Lewin said the probable-cause statement.
“She needed extensive assistance with bed mobility, transfers, dressing, eating, hygiene, toilet use, locomotion, transportation and shopping.”
Jeffrey Edgington, who allegedly had back problems, could provide only limited assistance to her, Lewin said.
The woman’s physical therapy team was unaware that the woman had a daughter, Lewin said.
Senior Staff Writer Paul Gottlieb can be reached at 360-452-2345, ext. 5060, or at paul.gottlieb@peninsuladailynews.com.
