What Can You Buy with $20 Million?

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52342343 - nurse taking care of sick elderly patient at home

What would you do with $20 million? Perhaps you’d invest in real estate or antiquities. Maybe you’d buy your own private island in the Florida Keys or venture into space tourism by purchasing a few seats aboard the Virgin Galactic. A registered nurse in Pearland, Texas attempted to commit $20 million in Medicare fraud until the Medicare Strike Force shut her illegal scam down.

The registered nurse (RN) from Texas at the center of today’s fraud article owned two home health care companies who provided services to Medicare beneficiaries. Over eight years, she and several co-conspirators carried out a scheme to submit $20 million in fraudulent claims for home health services that were not medically necessary or provided. (Most fraudsters who attempt this type of fraud tend to think that the government is unable to track their illegal acts. They could not be more wrong.)

The RN and her co-conspirators falsified patient records for Medicare beneficiaries who were not homebound, then billed the government healthcare program for services even though they did not qualify. (Government healthcare beneficiaries must be vigilant about verifying the claims submitted on their behalf to catch fraudulent transactions.)

To generate more income for her two home health companies located in Houston, the RN also employed patient recruiters to bring in additional Medicare beneficiaries. She also paid doctors to certify fake care plans for her Medicare patients. (That helped to keep the fraud wheel turning with a continuous influx of new patients.)

The business owner was investigated by the Federal Bureau of Investigation, and the Office of Inspector General at the Department of Health and Human Services. The case was brought as part of the Medicare Strike Force under the supervision of the Criminal Division’s Fraud Section and the U.S. Attorney’s Office for the Southern District of Texas.

Following a four-day trial, the 52-year-old Texan was convicted of Medicare fraud for attempting to steal $20 million from the program. A 47-year-old female co-defendant, who was also found guilty, is also awaiting sentencing.

Thanks to the Medicare Strike Force, which has charged over 3,500 defendants who have collectively falsely billed Medicare for more than $12.5 billion, this greedy woman has been stopped. While we don’t know what she had planned to spend the $20 million on, you can be assured that any dreams of spending tax payer dollars on luxurious vacations on a private island, an extravagant lifestyle lived in a humongous mansion or even a trip to Mars and are now out of reach, forever. (While we are not sure of this woman’s punishment yet, I’m guessing that this $20 million scam will cost the former RN and business owner her freedom.)

Today’s “Fraud of the Day” is based on an article entitled, “Registered nurse convicted in $20 million home healthcare fraud scheme involving two agencies,” posted on healthcarefinancenews.com on August 16, 2017.

A registered nurse and home health company owner has been convicted of conspiracy and multiple counts of healthcare fraud in a $20 million dollar scheme to defraud Medicare, the Department of Justice announced.

Evelyn Mokwuah of Pearland, Texas was convicted on one count of conspiracy to commit healthcare fraud and four counts of healthcare fraud for her role in a scheme connected to her two companies Beechwood Home Health and Criseven Health Management Corporation.

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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.