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To pull off a scheme capable of stealing $205 million from Medicare, there’s usually a multitude of players involved in a game that robs the elderly and the poor of medical benefits. An article posted on WPTV.com covers a man who was responsible for submitting more than $430,000 in false claims as part of the overall scheme.

The story states that a 45-year-old man was a patient recruiter for a now out-of-business partial hospitalization program (PHP) that purportedly provided intensive psychiatric services. The owner of the Miami-based business paid illegal health care kickbacks to the recruiter in exchange for patient referrals for residents at assisted living facilities throughout the Southern District of Florida. (As you might guess, the patients did not qualify for services and the PHP was not legitimate.)

The South Florida man pleaded guilty to one count of conspiracy to commit health care fraud. He is facing up to 10 years in prison when sentenced. (It is important to note that the owner of the company that this patient recruiter worked for is now serving 50 years in prison for masterminding the scheme.)

What might have started out as a game in the mind of the perpetrators, ended up having no winners – only losers. Because of the crimes committed by the owner and the patient recruiter, the poor and the elderly have lost out on deserved benefits. However, these two will also pay a high price for their selfish acts and will be unlikely to obtain a ”get out of jail free card” anytime soon.

Source: Today’s ”Fraud of the Day” is based on an article entitled ”Michael Mendoza Guilty in $205 million Medicare fraud scheme by recruiting patients for kickbacks” published on WPTV.com on June 20, 2014.

MIAMI – A South Florida man has pleaded guilty to recruiting patients in exchange for illegal kickbacks as part a $205 million Medicare fraud scheme.

Former Network Resource Consultant Inc. chief Michael Mendoza pleaded guilty to health fraud conspiracy Thursday in Miami federal court.

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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.