Family Togetherness

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47847021 - nurses pushing seniors in wheelchair thru nursing home

There are lots of activities that families can enjoy together, like playing card or board games, taking vacations at the beach or having a picnic in the park. A family from Jackson, Tennessee had a different idea of what family togetherness looks like. The father, mother and son were the masterminds of a healthcare fraud scheme that billed Medicaid, Medicare and Tricare more than $4 million for expensive power wheelchairs that were not needed.

The mother and father, who sold durable medical equipment such as power wheelchairs and back braces, were employed at the same durable medical equipment company where their son was the operations and sales manager. (That’s certainly convenient. I wonder if they carpooled together?) Together, the trio marketed wheelchairs to patients, telling them that Medicare would pick up the tab. (Sounds like a great deal on wheels.)

 The family enlisted an extensive network of illegally paid recruiters to find eligible patients. The mom and pop operation forged and faked documents to make it look like the patients qualified for the durable medical equipment. (A local doc and nurse practitioner were also in on the deal. They received kickbacks in exchange for faked physical exams.)

In court, many patient testimonies provided mounting evidence against the family who tried to pocket millions in taxpayer dollars. Some of the patients claimed the wheelchairs were too large to be used in their homes. They also testified that they were able to walk, drive and care for themselves, even though records were falsified to make it look like the patients were indigent. (The son jumped on the bandwagon by falsifying patient income and expenses to make it look like they were indigent.)

Another co-conspirator involved in today’s case was a sales representative that the son hired to help expand the company’s sales into Northern Mississippi. The sales rep was responsible for paying patient recruiters kickbacks for finding unsuspecting Medicare and Medicaid patients to participate in the fraud scheme. (The sales rep forged the signature of medical personnel who supposedly examined the patients and the son received a sales commission for each power wheelchair sold.) It was the sales rep who testified in the government’s case against the family. (He had previously pleaded guilty to healthcare fraud.)

 

After a three-week trial, the three family members who were involved in stealing millions of dollars from federal healthcare programs were convicted of healthcare fraud. The 67-year-old father, who happened to be the former principal at a Medina, Tennessee elementary school was convicted on 16 counts of healthcare fraud and paying illegal kickbacks. (Here’s a good argument for higher teacher salaries so they don’t have to resort to a life of crime.)

 

The former elementary school principal’s wife, also 67, was convicted on the same charges of healthcare fraud. Their 39-year-old son also received a healthcare fraud conviction for his part in the scam and for receiving more than $1.2 million in salary and sales commissions. Together, those family members will spend a total of 249 months in federal prison. (That just goes to show you that the family that defrauds together, goes to jail together.)

Today’s “Fraud of the Day” is based on a Department of Justice press release entitled, The Bailey Family Sentenced to a total of 249 months in Federal Prison for Defrauding Medicare,” released on August 17, 2018.

Jackson, TN – Following a three-week trial in February 2018, a federal jury convicted a married couple and their son, of health-care fraud offenses that led to millions of dollars lost to federal health care programs. A federal judge has sentenced them to a total of 249 months in federal prison. U.S. Attorney D. Michael Dunavant for the Western District of Tennessee announced the sentences today.

Sandra Bailey, 67 of Jackson, Tenn., was convicted of 16 counts, including conspiracy, health care fraud, and paying illegal kickbacks in connection with health care services. Her husband, Calvin Bailey, 67, was convicted of conspiracy. Their son, Bryan Bailey, 39, of Milan, Tenn., was convicted of conspiracy and wire fraud. The jury returned guilty verdicts on all 17 counts alleged in the indictment.

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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.