Mental Anguish

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It’s deplorable when a mental health services business takes advantage of vulnerable patients to make a profit. That’s exactly what happened in today’s “Fraud of the Day” case which involves the co-owners of a Henry County, Georgia mental health services business. They committed Medicaid fraud by altering patient records and billing the government healthcare program for more than $3.8 million in mental health services that were not performed.

The woman at the center of today’s article was from McDonough, Georgia. She co-owned and operated the mental health services business with a male partner. (Keep in mind, the business purported to provide interventions and counseling to youth and adults.) The partners in crime, plus two employees from their business, carried out the illegal scheme together. (There’s no doubt that the illegal billings caused a great deal of anguish for their victims, including Georgia’s Medicaid program.)

For nearly four years, the man and woman co-owners defrauded the Medicaid program while enrolled as providers. The co-owners and two female employees were charged with causing fraudulent billings and accepting payments they were not entitled to. (They created bogus documents to support the false billings.)

The 47-year-old mental health business owner pleaded guilty to one count of Medicaid fraud, one felony count of conspiracy to defraud the state and two felony counts of forgers in the second degree. She was sentenced to five years in prison to be followed by 10 years of probation. She must also pay $3,832,855 in restitution.

The woman’s business partner and the two employees who participated in the scam previously pleaded guilty to the scam. One employee received a sentence of five years on probation, while the other one will serve three years of probation. (All of these criminals are excluded from providing any services under any government healthcare benefit program in the future. Sounds good to me.)

While these four criminals from Georgia stole money from the government, the real disservice was to the patients they were supposed to help. Patients with mental health concerns are vulnerable and it’s possible that these thoughtless perpetrators made their patient’s situations much worse. (In this case, it was not the mental health business that made the intervention, but the government. The outcome was good – now these four criminals will never harm another patient.)

Today’s “Fraud of the Day” is based on an article entitled, “McDonough woman pleads guilty to Medicaid fraud, ordered to pay $3.8 million,” published by the Henry Herald on October 8, 2017.

ATLANTA – The owner of a former Henry County mental health services business will have to pay $3.8 million in restitution to the Georgia Medicaid Program for alleged Medicaid fraud.

Casandra Jones, 47, of McDonough and Frederick Thrasher owned and operated House of Preparation, which purported to provide mental health services to youth and adults. On Monday, Oct. 2, Jones pleaded guilty midway through her trial to one count of Medicaid fraud, one felony count of conspiracy to defraud the state and two felony counts of forgery in the second degree.

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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.