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 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.