Sending a Clear Message

47847021 - nurses pushing seniors in wheelchair thru nursing home

Sometimes it’s difficult to communicate a message in a way that it can be fully understood by the recipient. (Many people worry that they’ll hurt others’ feelings when trying to get their message across.)

Other times, that’s not the case. A story published in The Dallas Morning News details how the government sent a very clear and direct message regarding one woman’s involvement in a $375 million health care fraud scheme.

The article states that the woman was a nurse, who co-owned a home health care services company with her husband. Together, they billed Medicare more than $43 Million for unnecessary nursing care that was not provided in some cases.

Over a period of six years, the health care company owner’s scheme was reportedly enabled by a Dallas-area physician who orchestrated the single largest fraud case in the history of the Medicare Fraud Strike Force. (He was the doctor who certified patients to receive services from the health care company. He is also responsible for the placement of a six-month moratorium against home health care agencies in the Dallas and Houston areas by the Centers for Medicare and Medicaid Services.) The health care company in this case was the largest agency that was involved in the scheme.

The 52-year-old nurse pleaded guilty to her role in the conspiracy and faces up to 10 years in prison plus a $250,000 fine. Her husband previously pleaded guilty to health care fraud and was ordered to pay approximately $25 million in restitution. He is currently serving a 10-year federal prison sentence. The physician mastermind behind the scheme faces life in prison and has already lost his medical license.

Based on the sentencing received by the fraudster’s husband, it is possible that the woman may join her partner in crime behind bars soon. It remains to be seen what the final sentencing will be, but there’s no doubt that the government doesn’t worry about hurting criminals’ feelings. The message is likely to be loud and clear that if anyone attempts to victimize American taxpayers and the nation’s most vulnerable citizens, they will be caught and prosecuted.

Source: Today’s ”Fraud of the Day” is based on an article titled, ”Cedar Hill Nurse Admits Role in $375M Home Health Care Fraud,” written by Claire Z. Cardona and published by The Dallas Morning News on June 16, 2015.

A Cedar Hill nurse who co-owned a home health company pleaded guilty Tuesday to her role in a $375 million fraud conspiracy, federal prosecutors say.

Pat Akamnonu, 52, admitted conspiracy to commit health care fraud, according to a written statement from John Parker, acting U.S. attorney for the Northern District of Texas.

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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.