Paper Pusher

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Paper pushers are generally referred to in a derogatory manner because their job requires a lot of repetitive and monotonous work. (Some fraudsters excel at being paper pushers and can make a lot of money by repeatedly filling out fraudulent insurance claim forms, resulting in government benefit checks they do not deserve.) An article published in Focus Daily News details how two men stole $3 million from the Medicare program by filling out fraudulent claim forms.

The article states that for approximately five years, a home health care agency owner recruited Medicare beneficiaries to bill for unnecessary home health services. Along with the home health agency nursing director and others, he then created false medical records that stated patients required home health services. Another co-conspirator, who happened to be a doctor, falsely certified that the patients needed the home health services qualifying them for reimbursement under the Medicare program.

The 60-year-old doctor and the 49-year-old nursing director were each convicted for committing health care fraud. They received prison sentences of 120 months and 48 months, respectively. The doctor was also convicted on three counts of health care fraud and four counts of making false statements related to a health care benefit program. (This was connected to all of the false Medicare claims for bogus home visits or house calls that were never made.) The 56-year-old home health agency owner pleaded guilty to conspiracy to commit health care fraud and is scheduled to be sentenced.

These fraudsters probably never thought about the consequences of their fraudulent paper pushing acts, if actually caught. It looks like the Medicare Strike Force decided to push back and punish these perpetrators for their criminal acts. (I’m guessing that these two fraudsters will adapt to prison easily because there will certainly be a lot of monotonous and repetitive tasks to perform while serving out their sentence.)

Source: Today’s ”Fraud of the Day” is based on an article titled, ”Physician, Home Health Agency Nursing Director Sentenced in $3M Medicare Fraud Conspiracy,” published in Focus Daily News on December 26, 2014.

DALLAS—A physician and a home health agency manager were sentenced this week for their roles in a $3 million Medicare fraud conspiracy, announced U.S. Attorney Sarah R. Saldaña of the Northern District of Texas.

Joseph Megwa, M.D., 60, of Arlington, Texas, and Ebolose Eghobor, R.N., 49, of Grand Prairie, Texas, were sentenced today by U.S. District Judge Ed Knikeade to 120 months and 48 months respectively, in federal prison. In May 2014, Megwa and Eghobor were each convicted on one count of conspiracy to commit health care fraud. In addition, Mega was convicted on three counts of health care fraud and four counts of making false statements related to a health care benefit program based on his submission of false claims to Medicare for home visits or house calls to patients that he never actually made.

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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.