Unqualified and Unprepared

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Georgia resident Brenda Copeland owned and operated The Counseling and Training Center in Warner Robins. Despite not being authorized to run a group practice, Copeland was enrolled as an individual practitioner to provide mental health services to children. (Sounds like she needed to go to a training center herself.) In November 2021, she pleaded guilty to two felony counts of Medicaid Fraud.

As part of her Medicaid fraud scheme, she submitted billing for the group practice for up to 18 hours a day – including weekends, early mornings, and late evenings. (Unless she’s secretly Wonder Woman, these workdays are simply not feasible.) The bills were submitted in her name to cover her non-credentialed staff, who also were not authorized to provide services. (Because two wrongs make a right.)

 

Copeland provided care to vulnerable communities including Georgia’s children and older and at-risk adults when she was not qualified to do so. (This fraudster doesn’t sound equipped to give advice based on her own terrible life decisions.) Among the intentional lapses in her practice, Copeland enrolled Medicaid recipients who were not properly diagnosed by a licensed clinical professional. (This is a classic case of the blind leading the blind. These patients needed real mental health guidance, not counseling from unqualified and unprepared people.)

Being diagnosed by a licensed professional is a critical first step in authorizing treatment and billing claims for that recipient. To support this Medicaid fraud scheme, Copeland provided fake documentation attesting to each patient’s diagnosis. (That is just so wrong.)

Copeland was sentenced to ten years for committing Medicaid fraud, including two years to be served in prison with the remainder on probation. (Let’s see how she copes with time behind bars.) The Court also ordered restitution to the Medicaid Care Management Organizations impacted, Wellcare and Peachstate, in the amount of $631,843.00.

Today’s Fraud of the Day comes from an article, “Carr announces guilty plea, prison sentence for Charges in Medicaid Fraud,” published by Valdosta Today on December 6, 2021

“Georgia’s healthcare providers are an essential component of our Medicaid program, and we expect the best,” said Carr. “By violating public trust and stealing taxpayer dollars, Brenda Copeland harmed the very people in need of care – Georgia’s children and older and at-risk adults. This sentence sends a strong message that the state of Georgia will not tolerate this type of illegal and deceptive behavior.”

Copeland owned and operated The Counseling and Training Center in Warner Robins. Though she was not authorized to run a group practice, Copeland was enrolled as an individual practitioner to provide mental health services to children. In doing so, she submitted billing for upwards to 18 hours a day – including weekends, early mornings and late evenings – to cover for her non-credentialed staff, who also were not authorized to provide services.

 

 

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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.