Seeing Things in a Different Light

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How we see ourselves can be very different from how others see us. The owner and operator of a medical staffing company and home care services provider in Pennsylvania definitely saw herself in a different light than the government prosecutors who went after her for stealing more than $1 million from Medicaid. On the woman’s company website, she describes herself as an ”experienced nurse with impeccable skills.” However, a more accurate explanation may have been an ”experienced fraudster with impeccable skills in deception.”

Over a two-year period, the business owner carried out her scam by creating fake identification documents and bogus occupational licenses for some of her employees. She also submitted bills to Medicaid for services that were either not provided by her employees, were provided by someone other than the person that claimed to provide the services, or were not provided by a qualified employee at all. (That’s a pretty scary thought. Who would want to receive medical care from someone who was not qualified to give it?)

Although the woman had the right credentials and certifications to run her company, she was anything but impeccable. The 49-year-old pleaded guilty to making false statements about health care matters, engaging in monetary transactions involving criminally derived property and identity theft. She was sentenced to three years in prison and ordered to pay back $1,184,224 and forfeit $656,421.

In addition to claiming that she had ”impeccable skills,” the company website also stated that the business ”would not shield any errors or omissions to protect our image.” It looks like the government is holding this woman to her word. Let’s hope that she spends the next three years behind bars examining her lack of character and will emerge with a more accurate self-image and remorse for her illegal actions.

Source: Today’s ”Fraud of the Day” is based on an article entitled, ”Medical staffing CEO gets prison in Medicaid fraud case,” published by Central Penn Business Journal on December 22, 2016.

A Cumberland County businesswoman who admitted to scamming Medicaid through her Harrisburg-area medical staffing company must spend three years behind bars and pay back more than $1 million.

Rose Umana, 49, of Mechanicsburg, was sentenced Wednesday by U.S. District Court Judge Sylvia H. Rambo.

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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.