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A New Fraud Tool

Medical insurance application, silver pen and stethoscope. Legal law contract and health insurance concepts.
Senior Director of Strategic Alliances
LexisNexis Risk Solutions - Government

Today, we are going to do something a little different by highlighting how to use urinalysis as a fraud tool. Brought to you compliments of Donald Booker. Booker owned a urine toxicology testing laboratory along with a mental health and substance abuse treatment facility in North Carolina. To generate fraud business, Booker offered free housing in exchange for a urine sample. For those who don’t have a lot of housing options, this seemed almost too good to be true. And Donald Booker knew it.

From January 2016 to August 2019, Booker and his co-conspirator Delores Jordan, recruited Medicaid-eligible beneficiaries through Jordan’s subsidized housing programs. In the scheme, beneficiaries submitted mandatory urine specimens for drug testing as a condition of their participation. The one requirement for their urine sample? Take drugs. Zolanda Woods, a single homeless mom was a victim of this scheme.  She’d accepted a transitional housing spot in Greensboro that she describes as being infested with roaches and rats. She said that the staff made her provide regular urine samples.  “If you tested clean, you were punished,” Woods said. “They encouraged drug use. They just encouraged the worst of the worst to get the most money.”

Once staff received the urine samples, Jordan submitted them to a lab owned by Booker for testing. Booker’s company then submitted the fraudulent claims to NC Medicaid for the medically unnecessary tests performed by his lab. And Medicaid reimbursed them. In total Booker’s company submitted more than $20 million in claims to Medicaid and received more than $15 million in reimbursement.

Kudos to Zolanda Woods and her brave actions. After eight months, this mother of four had had enough. She said she’d approached Booker about the problems and was brushed off. She moved out and told Channel 9 News that she filed a formal complaint with the City of Greensboro. Now, she wants them to pay for what they did. “I want them to give back to the same community they victimized,” Woods said. We do, too Zolanda Woods.  We do, too.

Today’s Fraud of The Day is based on an article “Federal jury convicts Charlotte man for role in massive healthcare fraud scheme” published by WSOC TV on January 10,2023

A federal jury has convicted a man for his part in a massive healthcare fraud and kickback scheme. A federal indictment filed in Feb. 2022 lists Donald Booker, of Charlotte, and Delores Jordan, of Louisville, Kentucky, as co-conspirators who devised a scheme to defraud the NC Medicaid program.

The indictment said the pair filed more than $20 million in claims and received $15 million in reimbursements for urine drug testing services that weren’t medically necessary and didn’t meet Medicaid policy requirements.

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