Peace of Mind

314

It is estimated that 65.7 million informal and family caregivers provide care to someone who is ill, disabled or aged in the United States. These Americans have to balance the demands of work, home, kids and caring for a loved one who needs assistance. (To say that caregiving can be overwhelming is an understatement.) Home healthcare can be a great choice – one that is affordable and gives peace of mind to those who provide care and for individuals who want to be cared for in their own home. However, a Winterville, North Carolina woman disturbed the peace of mind of many when she committed Medicaid fraud by submitting nearly $50,000 in fraudulent claims through her home healthcare company.

The North Carolinian, who happened to be a registered nurse, owned a Greenville business that provided in-home personal care services for Medicaid recipients. Her employees helped the company’s clients with daily living tasks such as cooking, cleaning, bathing and hygiene.

Over two-and-a-half years, the business owner directed her personnel to falsify time sheets and care notes so that she could submit fraudulent billing claims to Medicaid for services that were not provided. (She generated even more revenue by paying her Medicaid clientele kickbacks to refer new customers her way. That is obviously illegal.)

 The home healthcare company owner pleaded guilty to two felony counts involving Medicaid fraud and the illegal kickbacks. She was sentenced to five years of supervised probation in Pitt County Court. If she violates her probation, she’ll be subject to 12 to 17 months in prison. (That’s definitely a huge incentive to obey the court order.) The fraudster must also pay back $49,438.48 of the taxpayers’ dollars to the North Carolina Medicaid fund.

Home healthcare has long been recognized for being vulnerable to fraud, waste and abuse. Billing Medicaid for services not provided not only wastes taxpayer money and drives up healthcare for all taxpayers, but also robs those who truly deserve the benefits of peace of mind and the care that they need.

 Fortunately, the government is getting pretty good about catching criminals who commit Medicaid fraud. In North Carolina alone, the Medicaid Fraud Control Unit conducted nearly 400 investigations and recovered $80,416,129 in improperly awarded funds. (That’s a great statistic that can restore peace of mind to all American taxpayers.)

 Today’s “Fraud of the Day” is based on an article entitled, “Winterville woman convicted on health care fraud,” published by Daily Reflector on October 31, 2017.

A Winterville woman pleaded guilty Monday to two felonies involving Medicaid fraud and illegal kickbacks, North Carolina Attorney General Josh Stein announced in a Monday news release.

Rosa Powell, age and address not provided, was sentenced to 60 months of supervised probation in Pitt County Court, the release said. She faces 12 to 17 months in prison if she violates her probation, the release said. She also will restore $49,438.48 to taxpayers via the state’s Medicaid fund.

SHARE
Previous articleThe Placebo Effect
Next articleDirty Dozen

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.