Diaper Duty

41913416 - medicaid torn newspaper headline on cash

A Columbus, Ohio man tried to dupe Medicaid by pretending to wear diapers so he could collect more than $250,000 in benefits he did not deserve. While Ohio is one of many states that currently offers incontinence supplies as part of its Medicaid coverage, this deceptive man clearly didn’t qualify. The successful Medicaid fraud scheme lasted for approximately seven years, until the flaws in his scam leaked out and landed him in prison. (I couldn’t help linking that word picture.)

The man, who was from the northeast side of Columbus, conspired with his girlfriend to carry out the Medicaid fraud scheme by faking a post-traumatic stress disorder (PTSD). While on diaper duty, the girlfriend pretended to be a home healthcare aide, while her boyfriend pretended to be incontinent and incapable of communicating. When caseworkers visited the disabled man on a monthly basis, the home health aide (his girlfriend) spoke for him. (That’s no surprise.)

During the seven-year scam, the defendant was anything but incontinent or incapable of communicating. After a caseworker observed the man driving a car, suspicions were raised and an investigation ensued. (The caseworker found out that the man had recently been in jail, where he showed absolutely no signs of disability.)

The man who supposedly had PTSD, worked as a painter during the seven years during which he was purportedly disabled. His cover was blown when investigators contacted his previous employer. During an interview with the contractor, the defendant called to request that the contractor explain that he had not worked for him in many years. (They say timing is everything.)

The 61-year-old man from Columbus pleaded guilty to Medicaid fraud and was sentenced to 14 months in prison for pretending to require diapers. The girlfriend was also charged with

Medicaid fraud; however, she unfortunately died before the case was resolved.

In addition to serving time behind bars, the surviving fraudster is required to pay $258,000 to the Ohio Department of Medicaid. This case is a perfect example of how seriously the government takes fraud and does whatever is necessary to properly dispose of anyone who tries to take advantage of vulnerable citizens who deserve government healthcare benefits.

 Today’s “Fraud of the Day” is based on an article,Northeast Side man sent to prison for Medicaid-fraud scheme involving him wearing diapers, published by The Columbus Dispatch on August 29, 2019.

A Northeast Side man has been sentenced to 14 months in prison after admitting to participating in a Medicaid fraud scheme that required him to wear diapers.

James McFadden, 61, was found guilty of one count of Medicaid fraud, a fourth-degree felony, in Franklin County Common Pleas Court.

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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.