Woman Pleads Guilty in $400K California Medicaid Fraud Scheme

OAKLAND, California—Maki Martinez-Gruninger pled guilty to a felony charge of defrauding California’s Medicaid program, Medi-Cal, after allegedly stealing more than $400,000 from the state of California through a scheme that exploited a disabled family member. California Attorney General Rob Bonta announced Martinez-Gruninger will serve two years in state prison.

The California Department of Justice (DOJ) received a complaint alleging that Martinez-Gruninger fraudulently claimed to be the in-home support services (IHSS) provider for a disabled family member. According to the complainant—who was the individual’s sole caregiver—they discovered in December 2019 that Martinez-Gruninger secretly applied to be the disabled family member’s IHSS provider in November 2007. As a result, Martinez-Gruninger allegedly submitted false claims to the IHSS program for more than a decade.

“Let this conviction serve as a clear warning to anyone attempting to defraud Medi-Cal: You will be found out and held fully accountable,” said Bonta. “Those who defraud these vital programs are not just breaking the law. They are stealing from taxpayers, endangering patient care and betraying the public trust. At the California Department of Justice, we will not tolerate it. We will continue to aggressively pursue those who abuse public programs for personal gain and hold them accountable to the fullest extent of the law.”

The investigation determined that Martinez-Gruninger unlawfully took the State of California’s Medi-Cal program money, intended to defraud the State of California and presented false IHSS and Respite Care claims for payment totaling $413,643.30. She pled guilty to a single felony count of Medi-Cal false claims.