Faking It Didn’t Make It

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There is no cure for Sickle Cell Anemia, an inherited condition where there are not enough healthy red blood cells to carry adequate oxygen throughout the body. (Some of the symptoms of Sickle Cell Anemia include swollen hands and feet, fatigue, or jaundice of the eyes or skin.) Fortunately, there are treatments that can help relieve the pain and prevent problems associated with the disease. A Richmond, Virginia woman committed Medicaid fraud by pretending to have the condition.

Today’s fraudster lied about her health to a multitude of healthcare providers – such as hospitals and ambulance services – in order to obtain benefits from the Medicaid program. She frequently claimed she needed pain killing drugs to combat Sickle Cell Anemia, a condition she did not actually have. (She preferred to receive a particular pain killer intravenously through her neck. Just thinking about that makes me want to pass out.)

In addition to requesting medical treatment for a condition she didn’t have, she did so under the identities of two different people who were actually Medicaid beneficiaries. That worked for her until she was ordered to have testing done. (After being tested at six different hospitals, her doctors determined that she did not have Sickle Cell Anemia. That put the kibosh on her scam.)

The 36-year-old Richmond, Virginia woman pleaded guilty to federal healthcare fraud and aggravated identity theft charges. She faces a prison sentence of between two and 12 years in prison for her scheme.

This woman was one of 412 charged defendants across 41 federal districts involving 115 doctors, nurses and other licensed professionals who allegedly participated in healthcare fraud schemes totaling approximately $1.3 billion in false claims. Of those, more than 120 defendants were charged for their roles in prescribing and distributing opioids and other narcotics. (This is one of the reasons why the opioid epidemic is out of control.)

To support her drug habit, this woman tried to fake her identity to receive painkillers she didn’t qualify for or need through Medicaid. (But, in this case, faking it didn’t make it.) The Medicaid Strike Force saw through her ruse and put a stop to the illegal drug use and the scam that stole medical benefits from America’s most vulnerable citizens.

Today’s “Fraud of the Day” is based on an article entitled, “Richmond Woman Faces Prison Time after Faking Sickness,” published on WTVR.com on August 9, 2017.

RICHMOND, Va. — A Richmond woman pleaded guilty Wednesday to federal healthcare fraud and aggravated identity theft charges.

Chermeca Harris, 36, a Medicaid beneficiary, misrepresented her health condition to health care providers in order to obtain health care benefits, according to court documents.

 

 

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Larry Benson
Larry Benson is currently the Director of Strategic Alliances for Revenue Discovery and Recovery at LexisNexis Risk Solutions. In this role, Benson is responsible for developing partnerships for the tax and revenue and child support enforcement verticals. He focuses on embedded companies that have a need for third-party analytics to enhance their current offerings.