Angela LaCroix, DAB CR6970 (2026)

DECISION

Petitioner, Angela LaCroix, resided in Pflugerville, Texas.  A home health agency hired her to provide her adult son with personal care services, for which the home health agency billed the Medicaid program.  Petitioner, however, claimed to have provided services that she did not provide.  She was caught, indicted, and pleaded guilty to theft. 

Based on her conviction, the Inspector General (IG) has excluded Petitioner from participating in Medicare, Medicaid, and all federal health care programs for a minimum period of five years, as authorized by section 1128(a)(1) of the Social Security Act (Act).  Petitioner appeals the exclusion. 

For the reasons discussed below, I find that the IG properly excluded Petitioner LaCroix.  Because the statute mandates a minimum five-year exclusion, the length of her exclusion is, by law, reasonable. 

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Background

In a letter dated March 31, 2026, the IG notified Petitioner that she was excluded from participating in all federal health care programs for a period of five years because she had been convicted of a criminal offense related to the delivery of an item or service under Medicare or a state health care program.  The letter explained that section 1128(a)(1) of the Act authorizes the exclusion.  IG Ex. 1 at 1. 

Petitioner timely requested review, and the matter is before me. 

Following a prehearing conference, I issued an order, dated May 28, 2026, directing the parties to submit briefs and documentary evidence.  Order and Schedule for Filing Briefs and Documentary Evidence (E-File # 4).  Pursuant to that order, on June 26, 2026, the IG submitted her prehearing exchange – a written brief (IG Br.) and five exhibits (IG Exs. 1-5). 

Petitioner did not submit a prehearing exchange, as ordered.  Nevertheless, she has not indicated that she has abandoned her appeal.  I will therefore decide this case based on the record before me. 

Because neither party proposes any witnesses, an in-person hearing would serve no purpose.  I close the record and issue this decision based on the parties’ written submissions.  See IG Br. at 3, 4, Order at 3-4 (¶ 7), Anil Hanuman, DAB No. 3080 at 11-12 (2022); Emery County Care and Rehab. Ctr., DAB No. 3006 at 5-8 (2020); James Brian Joyner, DAB No. 2902 at 12 (2018); CRDP ¶ 16(b). 

In the absence of any objections, I admit into evidence IG Exs. 1-5. 

Discussion

1.  Petitioner must be excluded from program participation for a minimum of five years because she was convicted of a criminal offense related to the delivery of an item or service under a state health care program.  Act § 1128(a)(1).1 

Under section 1128(a)(1) of the Act, the Secretary of Health and Human Services must exclude an individual who has been convicted under federal or state law of a criminal offense related to the delivery of an item or service under Medicare or a state health care program.  42 C.F.R. § 1001.101(a). 

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Here, a home health agency, “Touch of Class,” hired Petitioner as a personal care attendant for her adult son.  Petitioner reported to the home health agency that she provided her son with personal attendant services from 9:00 a.m. to 5:00 p.m., Monday through Friday.  The home health agency billed the Medicaid program for the hours Petitioner purportedly worked. 

But Petitioner also had a fulltime job outside the home.  From 7:30 a.m. until 4:45 p.m., she worked for the Pflugerville Independent School District.  IG Ex. 5 at 1.  She could not and, in fact, did not provide the personal attendant services for which the Medicaid program was billed. 

In an indictment, dated August 12, 2025, Petitioner was charged with theft of property – of between $30,000 and $150,000 in United States currency – from Touch of Class and from the Texas Department of Health and Human Services.  IG Ex. 4. 

On September 3, 2025, Petitioner “judicially confessed” to theft of property, as charged in the indictment.  IG Ex. 2. 

The Texas Court accepted her guilty plea and ordered ten years deferred adjudication.  The court also ordered Petitioner to pay $53,056.55 in restitution to the State Medicaid Agency, the Texas Department of Health and Human Services Commission.  IG Ex. 3; see IG Ex. 5. 

The Act and regulations provide that a person is “convicted” when “a judgment of conviction has been entered,” regardless of whether that judgment has been (or could be) expunged or otherwise removed.  Act § 1128(i)(1); 42 C.F.R. § 1001.2(a)(2).  Individuals who participate in “deferred adjudication or other program or arrangement where judgment of conviction has been withheld” are also “convicted” within the meaning of the statute.  Act § 1128(i)(4); 42 C.F.R. § 1001.2(d).  Based on these provisions, the Departmental Appeals Board characterizes as “well established” the principle that a “conviction” includes diverted, deferred, and expunged convictions, regardless of whether state law treats such actions as a conviction.  Henry L. Gupton, DAB No. 2058 at 8 (2007), aff’d sub nom. Gupton v. Leavitt, 575 F. Supp. 2d 874 (E.D. Tenn. 2008). Petitioner was thus “convicted,” within the meaning of the statute and regulations. 

Petitioner submitted fraudulent claims to her employer, who, based on her misrepresentations, billed the Medicaid program for them.  Petitioner’s crime is thus related to the delivery of services under a state health care program. 

By statute and regulation. an exclusion brought under section 1128(a)(1) must be for a minimum period of five years.  Act § 1129(c)(3)(B); 42 C.F.R. § 1001.2007(a)(2). 

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Conclusion

For these reasons, I conclude that the IG properly excluded Petitioner from participation in Medicare, Medicaid and all federal health care programs, and I sustain the five-year exclusion.