Taken for a Ride

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Most able-bodied people are capable of getting to doctor appointments on their own. An automobile, taxicab, bus, bike or train can usually get them there on time. However, convalescents or handicapped individuals often use an ambulette service, which provides a specially equipped motor vehicle for transporting recovering patients or the physically disabled. The Village Voice reports on a man who participated in a $13 million health care fraud scheme that took some Medicaid beneficiaries on a ride by paying and accepting illegal health care kickback payments through his ambulette transportation service.

The story reports that the man enticed Medicaid beneficiaries to obtain medical services, which they did not need. The fraudster transported the beneficiaries to a Brooklyn clinic, where he paid the employees a per-beneficiary cash kickback so that the medical clinic would accept the ambulette service’s beneficiaries as patients. The ambulette company then billed Medicaid for the transportation of the patients to and from their homes and the clinic. Once the beneficiaries were transported to the clinic, the man would pay the beneficiaries to continue to attend the clinic for medically unnecessary treatment including physician office visits, medical procedures, physical therapy and diagnostic testing. The medical clinic allegedly got their cut of the fraud pie by billing Medicare and Medicaid for the unneeded services.

The 57-year-old, who has pleaded guilty, is one of seven defendants in this fraud case which included other patient recruiters, the medical facility manager and clinic medical director. He now faces sentencing for his part in the elaborate kickback scheme. He will face up to five years in prison, $850,000 in fines, $429,000 in restitution and $429,000 in forfeiture.

The Medicare Fraud Strike Force scores again. Since its beginning in 2007, the organization has charged more than 1,500 defendants who have collectively billed the Medicare program for more than $5 billion. This fraudster tried to take U.S. taxpayers on a ride as well, but it looks like this guy will be taking a ride in a paddy wagon, straight to jail.

Source: Today’s ”Fraud of the Day” is based on an article titled, ”A Brooklyn Man Pleads Guilty to Involvement in $13 Million Medicare Fraud Scheme,” written by Raillan Brooks and published in The Village Voice on September 9, 2013.

BROOKLYN – A Brooklyn resident pleaded guilty to fraud charges in federal court on Friday. Gregory Konoplya, 57, will now face sentencing for his part in an elaborate kickback scheme that funneled $13 million in fraudulent claims from Medicare and Medicaid into a Brooklyn medical clinic.

According to court documents, between 2009 and 2012 Konoplya recruited Medicare and Medicaid beneficiaries with cash kickbacks, inducing them to attend the Cropsey Medical Care clinic in Brooklyn.

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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.