You’ve Been Warned

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Calculator and stethoscope on paperwork

Katrina Lynch, 39, of Texas, has been sentenced to serve 50 months in prison for defrauding Virginia Medicaid out of nearly $3 million. (For some Medicaid fraudsters, that’s just pocket change.)

Lynch owned a home healthcare service company, A Tender Heart, LLC, where she enrolled as a service facilitator with Virginia Medicaid. In this role, Lynch was in charge of ensuring required services were received by Medicaid recipients.

Between 2011 and 2018, Lynch submitted claims to Medicaid for services supposedly provided to beneficiaries. (Seven years of scheming, yet she never had any second thoughts about her illegal acts.) Lynch billed Medicaid for services that were never actually provided by A Tender Heart. (No surprise there. You could most definitely say she did NOT have a tender heart – more like a cold heart.) Lynch submitted bills to Medicaid for recipients who were transferred to other service facilitators, had not received visits from any company employees in months, were hospitalized, or had died.

Lynch allegedly received warnings during two audits from the Virginia Department of Medical Assistant Service (DMAS). During these audits, Lynch was warned about her questionable billing practices.

A Tender Heart was required to repay more than $355,000 to Virginia Medicaid as a result of the two audits. (Didn’t she know the rule, three strikes and you’re out?) Despite the warnings, Lynch continued to fraudulently bill Medicaid and collect money she was not entitled to. (Some fraudsters just never learn and are destined to repeat their mistakes.)

Over the course of six years, Lynch collected $2,816,633 from Virginia Medicaid. With her stolen funds, she travelled overseas, gambled at casinos, received cosmetic surgery, and purchased luxury jewelry and cars. (I hope the travelling memories made will last a lifetime since none of her other purchases will be available to her in prison.)

Today’s Fraud of the Day comes from an article, “Owner of Midlothian-based Company Sentenced to Prison for $2.8 Million Medicaid Fraud Scheme,” published by ABC News on July 20, 2021.

RICHMOND, Va. (WRIC) — The owner of a Midlothian-based company was sentenced Monday to 50 months in prison for defrauding the Virginia Medicaid program out of nearly $3 million.

According to court documents, Katrina Lynch, 39, of Cypress, Texas, owned and operated A Tender Heart, LLC. The home healthcare service company was reportedly enrolled with the Virginia Medicaid Program as a service facilitator, a provider that ensures Medicaid recipients receive needed and required services.

 

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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.