The Poor and Weary

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Close-up Of A Doctor's Hand Analyzing Report On White Desk

Fraudsters seek to exploit groups of individuals who are perceived as being most susceptible to their schemes. This includes targeting the elderly, low income individuals, those with disabilities, and anyone else they see as “easy” to manipulate.

A Texas man is the ringleader behind a Medicaid fraud scheme that paid individuals to solicit elderly and low-income residents for information, which was then used to fraudulently bill insurers. Patrick Siado was sentenced for his role in this conspiracy to fraudulently bill Medicare and the Georgia Medicaid program. 

Siado admitted that he and his co-conspirators hired individuals to obtain personal information and DNA swabs from low-income and elderly residents. (There are no lows fraudsters won’t sink to if it means they get to make money.) They paid the individuals $150 for each person they collected DNA and personal information from.

Siado and his co-conspirators obtained personal information that was used to fraudulently bill Medicare and Medicaid for genetic testing given to a “patient”. Siado would also receive illegal kickbacks from different labs involved in the scheme. Each test resulted in a kickback ranging from $100 to $575 and typically allowed a lab to bill Medicaid for more than $30,000. (That is a ridiculous amount of money to be charged.) 

Siado was sentenced to 51 months in federal prison for the Medicaid fraud scheme. He was also ordered to pay $50,075 in restitution by completion of his prison sentence. He must also serve three years of supervised release. (The irony is that Siado orchestrated  the scheme to get rich, but in the end, he will end up financially ruined.)

The Southern District of Georgia is taking part in a nationwide initiative to crack down on those who would seek to exploit Medicare and Medicaid programs. In the past year, they have charged over three dozen individuals and companies for schemes involving fraudulent genetic testing and unnecessary prescribing of orthotic braces or pain creams. (Same old, same old. Fraudsters really need to start getting more creative with their schemes.)  

Georgia law enforcement has identified more than $1.5 billion in losses to Medicare and Medicaid programs. (When criminals defraud these kinds of programs, it is the American taxpayer who pays the price.) Siado’s scheme is a perfect example of fraudsters attempting to take advantage of taxpayer funded healthcare programs, which are intended to aid elderly and low-income individuals.

Federal, state, and local law enforcement agencies across the country are dedicated to identifying and prosecuting healthcare frauds. If you suspect a healthcare professional of  Medicaid or Medicare fraud, please report it by calling 1-800-447-8477 or via email at HHSTips@oig.hhs.gov.

Today’s Fraud of the Day comes from an article, “Texas man sentenced to prison for scheme to fraudulently bill government medical insurance programs,” published by Insurance News Net on November 5, 2020.

AUGUSTA, GA: A Texas man has been sentenced to federal prison for organizing a scheme that paid workers to solicit elderly and low-income residents for information used to fraudulently bill government medical programs.

Patrick Siado, 39, of Houston, was sentenced to 51 months in federal prison and ordered to pay $50,075 in restitution by U.S. District Court Chief Judge J. Randal Hall after pleading guilty to one count of Conspiracy, said Bobby L. Christine, U.S. Attorney for the Southern District of Georgia. After completion of his prison sentence, Siado must serve three years of supervised release.

 

 

 

 

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Larry Benson
Larry Benson is currently the Director of Strategic Alliances for Revenue Discovery and Recovery at LexisNexis Risk Solutions. In this role, Benson is responsible for developing partnerships for the tax and revenue and child support enforcement verticals. He focuses on embedded companies that have a need for third-party analytics to enhance their current offerings.