Your affiant, James Murphy, is an investigator with the Medicaid Fraud Control Unit (“MFCU”) of the Minnesota Attorney General’s Office. As an investigator for the MFCU, I investigate allegations of billing fraud by health care providers enrolled in the Minnesota Medical Assistance Program (“Medicaid”). In this capacity, I investigated Jessica Jean Arneson ([DOB redacted]) (“ARNESON”), Defendant herein, and determined that ARNESON defrauded the Medicaid program by submitting false claims for Care Coordinator and Case Management services.
ARNESON falsely reported that she provided services to Medicaid recipients that she did not in fact provide, resulting in her employer billing Blue Plus for services not provided. ARNESON’s false representations caused Blue Plus to overpay a total of $185,959.84, $69,233.47 of which was paid to ARNESON as wages. I. The Medicaid Program The Medicaid program provides medical care and services to low-income Minnesotans (“recipients”) who meet certain income and other eligibility requirements. The Minnesota Department of Human Services (“DHS”), located in St. Paul, administers the Medicaid program.
DHS contracts with or enrolls Personal Care Provider Organizations (“PCPOs”) to furnish health care services to Medicaid recipients. PCPOs that contract with DHS submit claims directly to DHS to receive reimbursement for services. In some cases, DHS contracts with Managed Care Organizations (“MCOs”) to provide health care services to Medicaid recipients on a managed care basis. This is known as the Prepaid Medical Assistance Program (“PMAP”). DHS pays the MCOs a pre-determined amount for agreeing to provide the full range of Medicaid covered services to recipients.
The MCOs contract with other health care providers to provide services to recipients. Under this arrangement, providers submit claims directly to the MCOs, rather than to DHS, for the services they provide to recipients. The MCO in this case was Blue Plus, a component of Blue Cross / Blue Shield insurance, which had a service agreement with Mower County, Minnesota, to pay the county for managed care services provided by the county’s employees within the scope of the agreement. II. Fraudulent Claims Submitted by the Defendant Between at least May 2020 and August 2023, ARNESON was employed as a Care Coordinator for the Mower County Department of Health and Human Services, located in Austin, Minnesota (“the county”). ARNESON’s Care Coordinator position included providing case management services to qualifying individuals under the Medicaid program, and the county contracted with Blue Plus to provide eligible services to county residents.
The Medicaid code for case management authorizes reimbursement for time case managers spend coordinating care for persons with behavioral health needs, for example, connecting clients to services, advocating for client needs, and facilitating support services for client treatment. As an employee, ARNESON prepared and submitted documentation of her work that was subsequently converted into claims submitted by the county to Blue Plus. Under this arrangement, the county submitted claims for case management and other Medicaid-reimbursable services performed by its personnel to Blue Plus for payment, and the county passed along part of the reimbursement to such personnel, including ARNESON, as wages. 5 ••-CR-••-•••• Filed in District Court State of Minnesota 6/11/2026 Following a referral from Blue Plus, MFCU conducted an investigation of suspicious claims submitted for case management services by ARNESON. At the time of the conduct, ARNESON was a resident of Rochester in Olmsted County, Minnesota, and she was permitted by the terms of her employment to work remotely from Olmsted County.
