Three Strikes, You’re Out

12578261 - close-up portrait of a young female nurse

Baseball season is in full swing. It’s as good of a time as any to explain a few basic rules. Baseball players get three strikes per at bat. If they miss a pitch, don’t swing at a pitch in the strike zone, or hit a foul ball that is not caught, it’s called a “strike.” If the player gets three strikes, they’re considered “out.”  On the other hand, if a player gets a hit and can make it around the diamond to home plate without getting out, they score a “run.” (I assume you all know that, but just in case.) Today’s fraudster from Ogden, Kansas was in the home stretch and passing third base on quite a run when she got caught for Medicaid fraud.

Today’s fraud player was a licensed practical nurse (LPN) who worked in nursing facilities based in three locations – Clay Center, Junction City and Wamego. While on the job, the LPN forged opioid prescriptions for many of the patients that resided in the facilities where she worked. The nurse created quite the paper trail by altering medical records and forging signatures, so it appeared that nursing home residents were given opioids when they really had not. She also took advantage of internal procedures for discontinued prescriptions and intercepted deliveries from pharmacies to collect the opioid medications. (That’s a lot to keep up with. I’m sure she dropped the ball somewhere along the way.)

The 57-year-old pleaded guilty to Medicaid fraud and other related charges in the three Kansas counties where her workplaces were located. (Fortunately, for fraud investigators, she was stopped before she made it to home plate and beyond with her fraudulent scheme.) She received a sentence for each county where she committed Medicaid fraud. (She got 21 months in Pottawatomie County, 20 months in Clay County and 21 months in Geary County. Lucky for her, the three sentences will run concurrently.)

Suffice to say, this woman is not going to get taken out to the ballgame for peanuts and crackerjacks, just to jail for justice and correction. Looks like the home team (the government) hit a home run and beat this woman at her own fraudulent game.

Today’s “Fraud of the Day” is based on an article entitled, “Ogden nurse sentenced for Medicaid fraud,” posted on on January 17, 2019.  

TOPEKA, Kan. (AP) – A 57-year-old nurse has been sentenced to nearly two years in prison for Medicaid fraud and related charges in three Kansas counties.

Kathleen Kleuskens, of Ogden, was sentenced Thursday in Pottawatomie County to 21 months in prison. Earlier this month, she was sentenced to 20 months in Clay County and 21 months in Geary County. The sentences will run concurrently.

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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.