New Manager Needed

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Stethoscope on 100 dollar bills symbolizing financial surveillance

Despite the coronavirus pandemic, courts are still in session and hearing cases. One of the cases the Indiana Northern District Court will be handing down a sentence for involves Suzi Gawel, who stands accused of defrauding Medicaid of hundreds of thousands of dollars.

Gawel worked as an office manager at a company in Fort Wayne, where she sold medical equipment to clients across northern Indiana. Gawel’s work gave her access to privileged client information, which she stole to defraud Medicaid from January 2015 to October 2018. (I guess you could say she was excelling at one of her jobs, even if fraudulent. The average Medicaid fraud scam only goes undetected for about 16 months.)

The stolen data included patient’s names, addresses, date of births and Medicaid ID numbers. She used this information to submit reimbursement claims to Medicaid for unnecessary medical equipment. This equipment, which included oximetry devices and pneumatic compressors, were never ordered by physicians and therefore never delivered to patients. (These are expensive medical devices. Multiple reimbursements for these items could easily pay off a new car, a mortgage, or a beach house.)

More than 200 fraudulent reimbursement claims were issued on the behalf of patients. The money from the reimbursements was redirected into Gawel’s bank accounts. The fraud was discovered and investigated by the Indiana Attorney General’s Medicaid Fraud Control Unit, the Federal Bureau of Investigation Financial Crimes Task Force and the Organized Crime and Corruption Unit of the Indiana State Police. (This fraudster had the full weight of the U.S. Government working to put an end to her fraudulent schemes.)

This illegal reimbursement scheme cost Indiana Medicaid nearly $650,000. Gawel pleaded guilty earlier this year to charges of federal health care fraud and aggravated identity theft. Sentencing is set for Aug. 20 which may lead to Gawel serving prison time and paying more than $600,000 in restitution. (She’ll have to adapt from being behind a desk to behind the bars of a prison cell.)

In the meantime, Gawel has been released and will remain under supervision by the Pretrial Services Office pending sentencing. The court also ordered her to receive a psychiatric evaluation and to stay within the borders of northern Indiana.

Today’s Fraud of the Day comes from the article, “Hamilton woman convicted of federal fraud,” published by The Herald Republican on June 2, 2020.

FORT WAYNE — A Hamilton woman was convicted of federal health care fraud and aggravated identity theft Tuesday and will be sentenced in August.

Suzi Gawel, 57, pleaded guilty May 18. Tuesday, Indiana Northern District Court Judge Holly A. Brady signed the order and set sentencing for Aug. 20.

 

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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.