We granted certiorari to the Court of Appeals in these consolidated cases to determine where venue lies in the prosecution of cases of Medicaid fraud committed by a fraudulent scheme or device under OCGA § 49-4-146.1 (b) (1) (C). We hold that venue is proper in any county where an act was committed in furtherance of the fraudulent transaction. To the extent that the Court of Appeals reached a contrary conclusion in
Culver v. State,
Case No. S02G0997
In one count of a multi-count indictment returned in Fulton County, Michael J. Kell was charged with obtaining Medicaid benefits by a fraudulent scheme or device under OCGA § 49-4-146.1 (b) (1) (C). 1 The indictment alleged a fraudulent scheme which consisted of ordering urine drug screens for Medicaid recipients which were medically unnecessary, illegally processing those tests in a laboratory owned by Kell, and falsifying that fact when submitting claims for reimbursement by Medicaid. These acts occurred in Kell’s office in Fulton County, and Kell sought reimbursement from Medicaid by means of electronic billings from that location. The electronic billings were received and processed by Electronic Data Systems (EDS), the fiscal agent for Medicaid, located in DeKalb County. The processed Medicaid checks were accepted by Kell in Fulton County and some of those funds were deposited into a bank account in Fulton County.
Kell was tried in Fulton County, and was found guilty as charged. Although finding that the evidence was sufficient to support the verdict for Medicaid fraud, the Court of Appeals determined that reversal of that conviction was required because venue lies in DeKalb County where the fraudulent claims were received and processed by EDS. Culver, supra at 302 (1) (b). 2
Case No. S02G1144
JoAnn Cash was charged, tried, and convicted in Glynn County of two counts of Medicaid fraud under OCGA § 49-4-146.1 (b) (1) (C). Cash operated two counseling centers, one in Glynn County and one in Fulton County. The indictment alleged that Cash fraudulently submitted claims and received payment from Medicaid for services which were not performed or were not reimbursable under the program. Some of that documentation was generated in the Glynn County office. These requests for medical assistance payments were electronically transmitted to EDS in DeKalb County. The electronic billings were received and processed
As noted above, defendants Kell and Cash were charged in separate indictments with violating OCGA § 49-4-146.1 (b) (1) (C) of the Georgia Medical Assistance Act (“Act”), OCGA § 49-4-140 et seq., in that they obtained payments under the Act to which they were not entitled or in amounts greater than which they were entitled by use of a “fraudulent scheme or device.” 3 Both indictments specified overt acts in furtherance of the scheme to defraud which occurred in the counties in which the indictments were brought.
The Act contains no specific statutory venue provision. In the absence of such a provision, venue is determined by Art. VI, Sec. II, Par. VI of the Georgia Constitution which provides: “all criminal cases shall be tried in the county where the crime was committed.” OCGA § 17-2-2 (a) gives effect to this constitutional mandate by providing that “[c]riminal actions shall be tried in the county where the crime was committed, except as otherwise provided by law.” Thus, in determining the appropriate venue for the prosecution of Medicaid fraud, we look to where the “crime was committed.”
The proscribed conduct in both cases was the “obtaining” of medical assistance payments to which one is not entitled by means of a “fraudulent scheme or device.” OCGA § 49-4-146.1 (b) (1) (C). Studying “the key verbs which define the criminal offense in the statute is helpful in determining venue in doubtful cases.” (Citations and punctuation omitted.)
State v. Johnson,
Neither
Johnson,
supra, nor
State v. Barber,
Case No. S02G0997
Case No. S02G1144
In accordance with the foregoing, we now hold that prosecutions for Medicaid fraud under OCGA § 49-4-146.1 (b) (1) (C) may be brought in any county in which an act in furtherance of the crime took place.
Judgments reversed.
Notes
Kell and codefendant Michael D. Culver were jointly indicted and tried in Fulton County. They were both convicted as charged and filed consolidated appeals in the Court of Appeals. Culver’s conviction for Medicaid fraud under OCGA § 49-4-146.1 (b) (1) (C) was reversed because the evidence was legally insufficient to support the verdict.
Culver,
supra at 310 (5). Because Culver is not subject to retrial for this offense, see
Priest v. State,
Kell’s remaining convictions were affirmed. Culver, supra.
In addition to OCGA § 49-4-146.1 (b) (1) (C), other forms of Medicaid fraud are set forth in the statute. Subsection (b) (1) (A) is violated when a person obtains payments by “Knowingly and willfully making a false statement or false representation”; subsection (b) (1) (B) is violated when a person obtains or attempts to obtain payments to which they are not entitled by “ [deliberate concealment of any material fact.” Under OCGA § 49-4-146.1 (b) (2) it is unlawful for a “provider knowingly and willfully to accept medical assistance payments to which he is not entitled or in an amount greater than that to which he is entitled, or knowingly and willfully to falsify any report or document required under this article.” We do not reach the question of venue for alternative forms of Medicaid fraud under the statute.
But see
State v. Barber,
