Triple Punishment

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Medicaid covers approximately 13 percent of Nebraska’s population to include low-income children, pregnant women, adults, seniors and people with disabilities. According to the state’s Department of Health and Human Services, the government program contracts with about 80,000 medical providers to take care of those needing medical attention. One of those contractors was a mental health therapist who illegally billed Medicaid for more than $100,000 in mental health services. Her punishment for the Medicaid fraud incident requires her to pay back triple the amount she stole from the government.

The mental health therapist worked at a counseling agency in Chadron, which has a population of around 5,725. Even though the counselor was located in a rural area in the middle of the United States’ Great Plains, she still managed to submit 462 claims for 1,451 undocumented mental health procedures. (Either there were a lot of people in that area that needed help, or she was just making it all up.) In all, she illegally billed the Nebraska Medicaid program $102,955.60 for mental health services.

The counselor and her employer were investigated by the Attorney General’s Medicaid Fraud and Patient Abuse Unit. (It’s a sad state of affairs when there’s a specific group that investigates fraud and abuse. Then you know it’s a real problem.) The counselor eventually admitted that she failed to maintain documentation to support the bogus claims submitted over five years.

Per the Nebraska False Medicaid Claims Act, the mental health therapist was ordered to pay $308,866.80 in restitution to the government health benefits program for the improper billing practices. (Triple the amount that she stole.) It turns out that the counselor’s employer settled a separate action with Nebraska concerning the same incident. (I wonder if the employer knew what was going on or was blindsided?)

A report on Medicaid in Nebraska shows that 28 percent of the state’s 1.9 million residents are low-income. Twenty-one percent of the state’s general fund is spent on Medicaid, while 33 percent of all federal funds received by Nebraska is for Medicaid. The burden on the government healthcare program is already enormous, so when fraudsters unethically submit bills, the criminal steals from the government and robs those who qualify for and deserve medical care. (Here’s hoping that paying back three times the amount she stole with her Medicaid fraud scheme will make a lasting impression in this woman’s criminal mind.)

Source: Today’s “Fraud of the Day” is based on an article entitled, Chadron mental health therapist ordered to pay over $300,000 to statepublished in the Star-Herald on June 20, 2017.

Attorney General Doug Peterson announced today that a judge has ordered a Chadron-area mental health therapist to pay more than $300,000 to the state due to her improper billing practices.

Dawes County District Judge Travis O’Gorman ordered Anna Young to pay $308,866.80 after an investigation by the Attorney General’s Medicaid Fraud and Patient Abuse Unit found that she had billed Nebraska Medicaid $102,955.60 for mental health services. Young admitted that she knowingly failed to maintain documentation to support the submission of the claims, as required by law.  She was ordered to repay triple the amount that she billed to Medicaid, per the Nebraska False Medicaid Claims Act.

 

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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.