Ill-Equipped

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Medicare enrollment form and glasses

A greedy medical equipment supplier bilked Medicare for millions of dollars in a scheme to bill for equipment that was never furnished to patients. In 2018, Frances Jones, who owned and operated Oxicheck, a medical equipment supplier in Bisbee, Ariz., was charged with 12 counts of aggravated identity theft, one count of health-care fraud, and 42 counts of making false statements about a health matter. A related civil lawsuit cited Medicare losses of more than $3.2 million.

The indictment alleged that Jones filed nearly 2,000 fraudulent Medicare claims from 2013 to 2018. (What an industrious fraudster! Did she have any time left to actually provide medical equipment?)

Many claims were for equipment supposedly prescribed by doctors, who never even treated the patients. She created the fake claims by using identities of doctors and patients she had done business with in the past. (Creating bogus claims for medical equipment she never delivered, that was never prescribed by doctors who never treated the supposed recipients. Talk about a tangled web!)

If Jones had been found guilty of all 55 felonies, she faced a mandatory prison sentence of at least 20 years. (Given all the felonious activity, sounds well-justified!) Instead, she pleaded guilty to one count of healthcare fraud. In April 2021, Jones was sentenced to 36 months in prison, and ordered to pay $862,762.32 in restitution for losses to the Medicare Program.

Today’s Fraud of the Day comes from a press release the U.S. Attorney’s Office for the District of Arizona, “Owner of Southern Arizona Health Care Equipment company Sentenced to 36 Months for Defrauding Medicare,” dated April 13, 2021.

TUCSON, Ariz. – On April 9, Frances Jones, 52, of Chandler, Arizona, was sentenced to 36 months in prison by U.S. District Court Judge John C. Hinderaker. Jones previously pleaded guilty to health care fraud.

Jones, a licensed Medicare provider of durable medical equipment and the owner and operator of Oxicheck Northwest, admitted that she fraudulently billed Medicare between 2011 and March 2018 for durable medical equipment that was not provided to patients. Jones also used Medicare patient and medical provider identification without their knowledge or consent.

Additional information is from an Arizona Independent daily article, Bisbee Company’s Medicare Fraud Leads to Guilty Plea and Restitution Order,” dated June 2, 2020.

 

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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.