The Best Ever

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Medicaid can be considered the best health care plan that ever existed for people with low income and few assets. The government program provides coverage for myriad health problems, and beneficiaries don’t have to pay anything to receive medical treatment. Perhaps that’s why the woman in today’s ”Fraud of the Day” was intent on taking advantage of the program’s generous benefits administered through her home state of Tennessee. (Who wouldn’t like to receive nearly $17,000 in free health care?)

Tennessee’s Medicaid program—TennCare—provides health care for an estimated 1.3 million residents who are primarily low-income pregnant women, children, elderly or disabled. It is the only program in the United States that enrolls the entire state’s Medicaid population in managed care.

The story states that the defendant at the center of this case falsely reported her income in order to qualify for TennCare benefits. The 36-year-old got lucky and received four years of judicial diversion—a program for first-time offenders that eliminates jail time and destroys records of the offense after the probation period is successfully completed. However, she will have to pay restitution to the state in the amount of $16,775.82

Congratulations to the Office of Inspector General which has been in operation since 2005, investigating cases involving more than $3 million in repayments to the TennCare program and the avoidance of more than $163.3 million in costs. According to the article, this woman is one of 2,664 people that have been charged with TennCare fraud to date. (While this woman may have thought she could receive health care benefits for free, it turns out that the investigators in this case are the best at outsmarting attempts by fraudsters to steal from the nation’s most vulnerable citizens.)

Source: Today’s ”Fraud of the Day” is based on an article entitled, ”Williamson County Woman Must Repay State After Pleading Guilty to TennCare Fraud,” published by The Chattanoogan.com on July 6, 2016.

A Williamson County woman charged with TennCare fraud must repay the state for benefits received through the healthcare insurance program.

The Office of Inspector General (OIG) on Wednesday announced that 36-year-old Ryanne N. Cunningham of Nolensville was ordered to make restitution to TennCare in the amount of $16,775.82 after she pleaded guilty to TennCare fraud and theft of services. She also received four years judicial diversion in exchange for her plea.

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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.