AG Balderas Secures Conviction of Former Personal Care Organization Owner Who Defrauded Medicaid Program of Over $400,000

January 8, 2021
Contact: Matt Baca (505) 270-7148

Santa Fe, NM–Today, Attorney General Hector Balderas announced that the Office of the
Attorney General has secured a guilty plea from Lolita Begay-Yazzie to one count of
Fraud in excess of $20,000, a second degree felony, and one count of Failure to Retain
Documents, a fourth degree felony for defrauding New Mexico’s Medicaid program of
over $400,000. Begay-Yazzie owned and operated a personal care agency in Gallup,
New Mexico.
“Medicaid ensures that almost half of all New Mexicans have access to healthcare, and
we must do all we can to protect these resources that are so vital to our families,” said
Attorney General Balderas. “We will continue to hold anyone who tries to steal these
critical healthcare resources accountable.”
Begay-Yazzie billed New Mexico Medicaid as if her employees were providing care
services in excess of 24 hours in a day. Begay-Yazzie also overbilled Medicaid for more
services than each patient required to meet their needs according to their care plan.
Begay-Yazzie made withdrawals at ATMs in casinos in excess of $85,000.00 from the
personal care agency account.
The Court has ordered a pre-sentence report and will hold a sentencing hearing in the
coming months. According to the terms of the plea, Begay-Yazzie faces up to five years
of incarceration, and will be excluded from providing any Medicaid services in the future.
This case was investigated and prosecuted by the Office of the Attorney General’s
Medicaid Fraud Control Unit (MFCU). The MFCU receives 75 percent of its funding from
the U.S. Department of Health and Human Services under a grant award totaling
$3,200,478 for Federal fiscal year (FY) 2019-20, of which $2,400,360 is federally funded.
The remaining 25 percent of the approved grant, totaling $800,118 for FY 2019-20, is
funded by the State of New Mexico.