Fraudopoly

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Calculator and stethoscope on paperwork

Jonathan Sumter claimed to be providing behavioral health services to disabled, low-income people. But it turns out that he actually used the stolen identities of people with disabilities to game the system and collect over $1 million in Medicaid funds. Fun game!  . Just like “Pass Go and Collect $200” in the game of Monopoly, Sumter collected $5000 per stolen identity but playing the game of Fraudopoly instead.

From 2015 to 2019, Sumter operated a company known as PHC Supportive that claimed to offer rehabilitative behavioral health services through the Medicaid program. Except there was no legitimate business. Sumter founded the company strictly to fraud the government. This guy never even had the PHS company name on a square in Fraudopoly’s game board.

Everything was fake. He used stolen National Provider identifier numbers of nine healthcare professionals in order to create fraudulent invoices to submit to the Medicaid system.  Sumter used the stolen identities of 196 Medicaid members with severe mental and emotional health disorders without them even knowing. When questioned, caregivers and clients said that they had never received any services from Sumter nor PHS. And they couldn’t have because Sumter’s fake company had no employees! Although he billed service provider hours to Medicaid, he had stolen the identities of service providers from other companies to do so.

Sumter does not “Pass Go and Collect $200” this time. On January 6, 2023, he was sentenced to over seven years in federal prison for the theft of government funds.

Great job by the U.S. Department of Health and Human Services in this case.

Today’s Fraud of The Day is based on article “Man guilty of using stolen identities of mentally disabled people to bilk government of $1M” published by The State on January 6, 2023

A Greer man stole more than $1 million from Medicaid by submitting fake bills for treating low income mentally disabled people. United States District Judge Donald C. Coggins sentenced Jonathan W. Sumter to 7.6 years in federal prison and required him to repay $1,055,373.66 to South Carolina Medicaid. Sumter pleaded guilty to theft of government funds.

Assistant United States Attorney T. DeWayne Pearson told the court Sumter founded PHC Supportive Services ostensibly to provide rehabilitative behavioral health services, but never had any clients. TOP VIDEOS × Sumter billed Medicaid using stolen National Provider Identifier numbers of nine health care professionals from 2015 to 2019.

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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.