Benefit Buffet

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Fraudsters tend to see government benefit programs as a smorgasbord serving up an abundance of free money. A business owner, who operated six substance abuse counseling centers in Oklahoma, received more than $1.5 million in Medicaid reimbursements she did not deserve.

It is reported that the mother started the counseling center because of her daughter, who struggled with alcoholism. In an article posted on KXII.com, she stated that she wanted to go to work every day with the goal of helping people. (Technically speaking, she helped herself gain access to government benefits, not people.)

The scam was carried out by altering dates and times of service and by double-billing under variations of the same name. She submitted claims to Medicaid stating she had provided services, when she was actually on vacation, or at a wedding or a funeral. Apparently, she also hired unqualified employees.

As a result of this woman’s illegal acts, she was able to obtain $1.5 million in undeserved reimbursements before a former employee blew the whistle on her scam. (The former business owner explained that an employee signed in under her name and submitted the claims to Medicaid without her knowledge.)

The judge didn’t buy the fraudster’s explanation and ordered her to pay back more than three times the amount she stole. In all, she owes $4.7 million in restitution and fines. Another related case is pending for a woman who worked for the former counseling center owner.

This fraudster obviously wanted to feast on free benefits, but it appears her eyes were too big for her stomach. Unfortunately, she bellied up to the government benefits buffet too many times and now she has been left to pick up the check.

Source: Today’s ”Fraud of the Day” is based on an article entitled, ”Atoka business gets $4.7 million judgment for Medicaid fraud,” posted on KXII.com on August 12, 2016.

ATOKA, Okla. – Lexie Batchelor said she started LXE Counseling in Atoka in 2010 after having a daughter who struggled with alcoholism.

”I go to work every day and I try to help people,” Batchelor said.

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Larry Benson, Senior Director of Strategic Alliances, LexisNexis Risk Solutions - Government

Larry Benson is responsible for developing strategic partnerships and solutions for the government vertical. His expertise focuses on how government programs are defrauded by criminal groups, and the approaches necessary to prevent them from succeeding.

Mr. Benson has 30 years of experience in sales and business development. Before joining LexisNexis® Risk Solutions, he spent 12 years founding and managing two software technology startups. During the 1990s he spent 10 years as a Regional Director helping to grow a New England-based technology company from 300 employees to 7,000. He started his career with Martin Marietta Aerospace working on laser guided weapons and day/night vision systems.

A sought-after speaker and accomplished writer, Mr. Benson is the principal author of “Fraud of the Day,” a website dedicated to educating government officials about how criminals are defrauding government programs. He has co-authored WTF? Where’s the Fraud? How to Unmask and Stop Identity Fraud’s Drain on Our Government, and Data Personified, How Fraud is Changing the Meaning of Identity.

Benson holds a Bachelor of Science in Physics from Albright College, and earned two graduate degrees – a Master of Business Administration from Florida Institute of Technology, and a Master of Science in Engineering from Lehigh University.