Meaningful Consequences

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Cute baby girl with her mother at paediatrician's office.Female doctor examining cute baby girl

Medicaid providers who steal from the government healthcare program by billing for services they don’t deliver eventually face severe consequences for committing Medicaid fraud. That is the message received (loud and clear, might I add) from federal prosecutors in Georgia who recently won major civil judgments against a Medicaid provider and the business owner they say stole from the state program for years.

The U.S. District Court for the Southern District of Georgia ordered the Brunswick-based Miracle Home Care Inc. to pay $9.7 million and its owner to pay $400,000 to the government. The two were found to have repeatedly filed false claims for thousands of dollars in fraudulent non-emergency transportation and adult health services, including falsifying thousands of records. (It was a miracle they weren’t caught sooner.)

The Medicaid program provides health benefits to low-income families who either have no medical insurance or inadequate medical insurance. The federal government establishes the general Medicaid guidelines, but program requirements are established and monitored by each state.

Medicaid Fraud Control Units operate in 49 states and Washington, D.C. In fiscal 2017, they recovered $1.8 billion from fraud cases that included 1,528 criminal convictions involving $693 million and 961 civil judgments worth $1.1 billion, according to the U.S. Department of Health and Human Services’ Office of Inspector General.

If you suspect fraud, report it to your state Medicaid office to prevent fraudsters from taking advantage of vulnerable beneficiaries who deserve to receive these government healthcare benefits.

Today’s Fraud of the Day comes from a U.S. Attorney’s Office for the Southern District of Georgia press release, “Government obtains $10.1 million in judgment to resolve Medicaid fraud claims in False Claims Act complaint,” published on Dec. 17, 2019.

BRUNSWICK, GA:  A Brunswick Medicaid provider and its owner have been ordered to pay more than $10 million to settle a civil fraud complaint filed by the federal government and the state of Georgia.

The judgments, approved by the U.S. District Court for the Southern District of Georgia, awards the government $9.7 million against Brunswick-based Miracle Home Care, Inc. and $400,000 against its owner, Shashicka Tyre-Hill of Brunswick, said Bobby L. Christine, U.S. Attorney for the Southern District of Georgia.

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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.