Well-earned Punishment

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Usually, most people like to be rewarded for their efforts with a pat on the back or a sentiment such as ”good job.” Three people at the center of today’s ”Fraud of the Day” accomplished stealing $3 million from Medicaid and as a result, they received a well-earned punishment from the government.

The three defendants at the center of this case were all employed by a home healthcare services provider with offices in Cleveland, Ohio. The scam began when they first submitted false documentation to become an accredited home healthcare provider. Once approved, they then forged documentation to make it look like doctors had approved specific care plans they had developed for their patients.

The scam, which continued over four years, also involved the fabrication of bills that showed that home health visits had occurred when in reality, they had not taken place at all. (The three fraudsters received payment of more than $3 million as a result of the fraudulent claims.) One of the defendants even recruited patients by paying cash kickbacks. The three defendants each received prison sentences ranging from 27 months to 46 months for defrauding Medicaid by billing for services that were not provided.

These criminals not only stole millions from the government healthcare program, but also from the public. With each defendant’s sentence, the government recognized these frauds with a well-earned punishment. (This sends a clear message to anyone else who aspires to defraud the government in a similar manner.)

Source: Today’s ”Fraud of the Day” is based on a Department of Justice press release entitled, ”Three sentenced to prison for $3 million fraud involving Cleveland home health company,” released on December 8, 2016.

Three people were sentenced to prison for their roles in a $3 million conspiracy involving a home health service company with offices in Cleveland to defraud government insurance programs by billing for services not provided, law enforcement officials said.

George Epps, 43, of Cleveland, was sentenced to 46 months in prison.

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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.