Benched

99

According to Medicaid.gov, the government health benefits program is the largest payer when it comes to mental health services in the United States. (And as you know, where there’s a large pot of money, there’s usually a fraudster or two plotting to make it theirs.) An article posted on KOLOTV.com tells how a woman used her company and her vulnerable patients to steal money from the government.

The article states that the woman at the center of this case operated a behavioral health services company in Northern Nevada called ”No Child Left Behind Behavioral Health Services” where Medicaid services to children were supposedly provided. (In reality, the woman and her company billed Medicaid for services that in many cases were never provided to her patients.)

The 39-year-old business owner was found guilty of intentional failure to maintain adequate records and her business was found guilty of submitting false claims. While the company was ordered to pay $100,000 in restitution, the judge suspended a jail sentence for the fraudster and placed her on probation for two years. During that time, she will be required to serve 200 hours of community service. (Perhaps spending a little time with the people she defrauded may be the best experience.)

This woman may have had an initial intent to help her juvenile patients when she set up her business, but somewhere along the way she became corrupt. (She not only left the children behind, but she also threw them under the bus so to speak. All for her own personal gain.) The tagline for her company implied that the business intended to work together as a team with the intention of making a difference in the community. (They made a difference alright, but unfortunately a bad one at the expense of her victims which include her patients as well as taxpayers.) Since she was not a team player in this case, she has been rightfully benched and is out of the fraud game.

Source: Today’s ”Fraud of the Day” is based on an article entitled, ”Reno owner of No Child Left Behind services guilty of fraud” posted on KOLOTV.com June 9, 2016.

RENO, Nev. (AP) – A northern Nevada company doing business as No Child Left Behind Behavioral Health Services and the 39-year-old Reno woman who owns it have been convicted of federal fraud for billing Medicaid for children’s services never provided.

Nevada Attorney General Adam Laxalt said Thursday Candia Alea Tolbert was found guilty of intentional failure to maintain adequate records, and her business guilty of submitting false claims.

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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.