High Priority

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The government places a high priority on preventing the loss of Medicare health care dollars, particularly in the area of durable medical equipment (DME) where services and supplies offered are vulnerable to fraud. An article published by the Daily Breeze tells about a registered nurse and former owner of a medical supply company who managed to bilk more than $8.3 million through his business.

The story states that for more than six-and-a-half years, the former owner of the DME supply company paid cash kickbacks to patient recruiters in exchange for patient referrals. He also paid kickbacks to physicians for fraudulent prescriptions for medically unnecessary services and supplies, such as power wheelchairs. (Unfortunately, the love of cold, hard cash can persuade physicians even though they know that the fraudulent prescriptions are a no-no.)

The man used the bogus prescriptions to submit $8.3 million in claims to Medicare for durable medical equipment that was not medically necessary. (Medicare paid nearly $4.3 million for the fake claims.)

Court reports state that the 42-year-old man was convicted by jury for conspiracy to commit health care fraud, seven counts of health care fraud and one count of money laundering. He was sentenced to four years in federal prison and ordered to pay back more than $4.3 million in restitution, jointly and severally with a co-defendant.

Congratulations to the Medicare Fraud Strike Force once again. The organization, which was set up by the government to increase the accountability and decrease the presence of fraudulent providers, has clearly indicated that stopping fraud is a high priority.

Source: Today’s ”Fraud of the Day” is based on an article titled, ”Carson Woman Sentenced to Prison for $8.3 Medicare Fraud Scheme,” published by the Daily Breeze on May 11, 2015.

A registered nurse from Carson who owned a medical supply company was sentenced Wednesday to four years in federal prison for her role in an $8.3 million Medicare fraud scheme.

In addition to the prison term, U.S. District Judge Christina A. Snyder ordered Olufunke Fadojutimi to pay nearly $4.3 million in restitution, according to the U.S. Department of Justice.

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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.