Head Check

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According to an article published in the News & Observer, a North Carolina woman, who ran a counseling business, scammed Medicaid by using patient ID numbers to bill the government benefits program for services that were not needed nor provided. (Did I mention the ID numbers did not belong to her patients?)

The story states that the 46-year-old woman’s business provided mental health assessments and treatment from two offices. The victims of the scheme testified that they had never heard of the counselor or her practice. (They weren’t even her patients.) Through her fraudulent billing practices, the deceptive woman was able to bilk approximately $1 million from Medicaid. (It would be interesting to know how she obtained the beneficiary ID numbers.)

The counselor pleaded guilty to health care fraud and money laundering. She could get up to 10 years in prison for her illegal billing practices. The criminal also will have to make restitution to the Medicaid program.

While this article does not mention if the perpetrator was licensed to provide mental health services, this woman has violated a long list of ethics that are common to the mental health profession. Licensed counselors have to agree to not harm, but protect the welfare of their patients. Unfortunately, in this case, this defendant did cause harm to her victims and those beneficiaries who deserve to have mental health services. (Let’s hope that the judge will order a mental health assessment for this defendant in hopes that she will receive the treatment she needs in order to function as a mentally healthy adult.)

Source: Today’s ”Fraud of the Day” is based on an article titled, ”Counseling Service Owner Pleads Guilty to Medicaid Fraud,” published by the News & Observer on September 3, 2014.

GREENSBORO — A Person County resident who operated a counseling service with offices in Durham and Fayetteville has been convicted in federal district court of a scam that cost the Medicaid system about $1 million, officials said.

Tracie Yvette Clay, 46, who lives in Timberlake, pleaded guilty to health-care fraud and money laundering, U.S. Attorney Ripley Rand said in a statement Tuesday.

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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.