There’s Nothing Wise About Committing Fraud

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41913416 - medicaid torn newspaper headline on cash

Americans are all too familiar with the devastating effects of opioid abuse. On average, 130 Americans die every day from an opioid overdose, according to the federal Centers for Disease Control and Prevention. What is less known is the role Medicaid plays in that.

Non-elderly people with opioid use disorder are disproportionately covered by Medicaid, research shows. And, sadly, some physicians negligently write opioid prescriptions for people who shouldn’t have them, and then bill the drugs and services to Medicaid. (That forces taxpayers to pick up the bill on the deadly trend of opioid addiction.)

A Virginia doctor and his wife are awaiting sentencing after pleading no contest last summer to 15 felonies each involving drug distribution, prescription fraud, and Medicaid fraud. They were charged in 2018 with more than 100 counts each.

The couple, who are in their 70s, ran the Appalachian Medical Clinic near Wise, Va. (although there was nothing wise about their alleged actions). One of their employees, Deborah Fugate, 55, of Appalachia, Va., also pleaded no contest in July to two counts of prescription fraud and two counts of conspiracy to commit medical fraud. In December, she was sentenced to 10 years in prison. A judge suspended all of the sentence, but she will be under court supervision for 10 years.

The three were charged in 2018 after local, state and federal law enforcement raided the medical clinic, which operated in one of the nation’s hardest hit areas in the opioid epidemic. Those initial court filings said Dr. Michael Ford signed prescriptions for his staff, and then falsified documents. He prescribed various forms of opioids and stimulants, according to reports.

Today’s Fraud of the Day comes from the article, “Appalachia woman escapes jail time in prescription fraud case,” published Dec. 11, 2019 on wycb.com, News Channel 5, and “Appalachia, Virginia, physician, wife and employee face charges,” published Aug. 22, 2018 in the Washington County News.

An Appalachia, Virginia, physician, his wife and an employee have been indicted on dozens of charges related to drug distribution, obtaining drugs by fraud, prescription fraud and Medicaid fraud.

Dr. Michael B. Ford, of Big Stone Gap, operated the Appalachian Medical Clinic in Wise County and currently faces 124 charges. His wife, Una Faye Ford, faces 110 charges. She worked with her husband and assisted in the conspiracy, according to court records released Thursday.

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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.