When Lying is a Felony

Closeup rear low angle view of an early 60's senior gentleman having some back pain. He's at doctor's office having medical examination by a male doctor. The patient is pointing to his lumbar region.

There are lies, and then there are lies. Given the subject, some are a way to spare someone’s feelings; others are a lapse in moral turpitude. (One thing is for certain though, lying on a government document is fraud – and a felony.)

As an example of how serious the government takes such lies, a 71-year-old doctor in Baton Rouge, La., has been sentenced to 18 months in federal prison for workers’ compensation fraud. He filed false information with the U.S. Labor Department’s Office of Workers’ Compensation Program.

As part of his practice, Dr. Marvin Clifton provided physical therapy that included treatment for federal employees who received workers’ compensation benefits for having a medical condition that prevented them from working. He directed his office staff to falsify medical bills claiming that he had provided treatment for patients receiving workers’ compensation. (In this case, it was nine U.S. Postal Service workers.) Clifton’s office filed for reimbursement on more than $500,000 of falsified bills, for which he received $340,342 over four years ending in January 2019.

Clifton pleaded guilty to workers’ compensation fraud for making false statements to the Office of Worker’s Compensation Program. Besides the 18 months in prison, he was sentenced to two years of supervised release and a $50,000 fine.

Cheating workers’ comp programs is “not a victimless crime,” said U.S. Attorney Brandon J. Fremin, who prosecuted the case. “It jeopardizes healthcare resources and steals taxpayer money meant to treat federal workers with real injuries and illnesses.”

Today’s Fraud of the Day comes from a U.S. Justice Department press release, “Baton Rouge Doctor Sentenced to Federal Prison for Making False Statements Relating to Health Care Matters,” issued March 12, 2020.

United States Attorney Brandon J. Fremin announced that U.S. District Judge Brian A. Jackson sentenced Marvin Clifton, M.D., age 71, of Baton Rouge, Louisiana, to 18 months in federal prison following his conviction for making false statements relating to health care matters.  The Court further sentenced Dr. Clifton to two years of supervised release following his term of imprisonment, and ordered him to pay a $50,000 fine and a $100 special assessment.

According to admissions made as part of Dr. Clifton’s guilty plea, Dr. Clifton was a licensed physician whose medical practice included physical therapy.  His patients included individuals that received medical benefits under the Office of Workers’ Compensation Program (“Workers’ Comp Program”).  The Workers’ Comp Program was a federal health care benefit program, providing wage replacement benefits, medical treatment, vocational rehabilitation, and other benefits to certain workers or their dependents who experienced work-related injuries or occupational disease. Qualified medical treatment provided under the Workers’ Comp Program was paid for by the U.S. Treasury.

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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.