The Apple Doesn’t Fall far From the Tree

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Listen to this StoryWKYC-TV reports that two women in the greater Cleveland area used state Medicaid programs for extensive personal enrichment. The story states that a mother and her daughter (there are so many reality TV shows now, but this story gives me the idea for a new one: Fraud Moms) were both sentenced on October 15, because they ran a Medicaid conspiracy between 2006 and 2014, which netted the pair $18 million. (I know Cleveland was especially hit roughly by Rust Belt decline, but surely there are better economic opportunities than profiteering by defrauding the Medicaid system.)

The story explains that both women were found guilty of defrauding Ohio’s Medicaid system, as well as aggravated identity theft. The younger fraudster, who resides in Richmond Heights, OH, was ordered to pay $18 million in restitution and sentenced to nearly eight years in prison. She and her mother owned and operated a home health care firm which requested and received millions in in Medicaid reimbursements while it was still in its period of exclusion from the federal health program. The story states that the mother must serve a five year supervised release sentence, fulfill 300 hours of community service obligations and pay more than $400,000 in restitution. (These are two extensive sentences for excessive fraud.)

In addition to illegally receiving and cashing out millions in Medicaid reimbursements, the story notes that the mother fraudster helped employees with previous criminal histories and related criminal records to forge their background checks. She also paid her daughter more than $2.2 million over the course of their eight year endeavor, despite the fact that the Medicaid program did not recognize her daughter as eligible for Medicaid reimbursement. (This mom plays by her own rules. Maybe she told the judge it’s not unconstitutional to employ your daughter!)

Although this mother-daughter duo were eating from the fraud buffet for more than eight years, thankfully law enforcement professionals are serving them with just desserts. Once they leave prison, hopefully they can put their ingenious capacity to navigate state and federal bureaucracy to more legal and productive uses.

Source: Today’s ”Fraud of the Day” is based on an article titled, ”Richmond Heights woman sentenced for healthcare fraud,” and published by wkyc.com on October 15, 2015.

CLEVELAND — A Richmond Heights woman will spend nearly 8 years in prison for operating an $18 million home health care fraud scheme.

Sharon Ward, 45, was sentenced to 94 months in prison and ordered to pay $18 million in restitution after being found guilty of health care fraud and aggravated identity theft.

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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.