From Fraud to Worse

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42947095 - prescription form lying on table with stethoscope, pen and pile of pills fell out from jar. medicine or pharmacy concept. tablets and recipe.

The Omaha World-Herald has the troublesome story of a woman who defrauded Medicaid of more than $200,000 by submitting false claims for mental health and substance abuse counseling. This same woman, the report states, last year struck and killed a pedestrian with her car. (The article does not make any connections between the two acts, which might be sadder still.)

According to the article, the car accident occurred because the driver was reaching for her cellphone, which had fallen to the floor of her car, when she hit a middle-aged woman who was removing items from her own vehicle’s trunk. The victim died four days later. The driver was sentenced to nine months in jail, having been found guilty of misdemeanor motor vehicle homicide.

The article does not provide details about how the woman’s fraud was uncovered, only that it occurred between 2008 and 2014, before the accident (when her need for counseling would have been obvious). In that time period, she submitted a whopping 1,599 claims. Even after the Nebraska Attorney General’s Office discovered that her claims contained falsified information around a subcontractor that did not exist and sued her for bilking the health care program out of $208,506, she went on to file a motion for a rehearing, which the presiding judge promptly denied. Instead he ordered her to pay back 150% of the money she stole. (No need to whip out your calculator; it’s $312,759 in restitution.)

Two terrible crimes: one stemming from years of deceit and the other from reckless behavior. One robbed the government and taxpayers and the other robbed an innocent woman of her life. There’s usually a bright side when fraudsters are brought to justice. But not always.

Source: Today’s ”Fraud of the Day” is based on an article titled, ”Woman who struck, killed pedestrian must pay state $300,000 for Medicaid fraud,” written by Emerson Clarridge and published by the Omaha World-Herald on March 5, 2016.

An Omaha motorist who struck and killed a pedestrian with her vehicle last year has been ordered by a judge to pay about $300,000 to the State of Nebraska because she fraudulently submitted Medicaid claims for mental health and substance abuse counseling.

Lawanda Cook, 42, submitted 1,599 claims from 2008 to 2014 to Nebraska Medicaid and a subcontractor for which no clinical records exist and was paid $208,506, the Nebraska Attorney General’s Office alleged in a civil suit.

A Lancaster County District Court judge overruled a motion for a rehearing that Cook filed and ordered Wednesday that she pay $312,759, 1½ times the amount of the claims.

Cook was sentenced in September to nine months in jail after she was found guilty of misdemeanor motor vehicle homicide.

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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.