Lies Beget More Lies

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There are several types of lies. (For example, white lies are intended to be polite; fabricated or exaggerated statements are somewhat true, but a little bit false; lies of omission fail to disclose known information and lies of commission are basically a blatant lie.) An article published in The Press Enterprise tells about a man who told a lie of commission, then lied about his lie to investigators who were looking into a scam that stole more than $1 million from Medicare.

The story states that the man who lied to investigators was the former general manager of an ambulance company, which primarily provided non-emergency transportation for Medicare patients needing dialysis treatments. The former manager helped to carry out the scam by instructing the ambulance company’s medical technicians to conceal patients’ medical conditions through altered paperwork that justified their ambulance transportation.

Over a three-month period of time, the former manager conspired with company owners and the company’s training supervisor to submit more than $5 million in fraudulent claims to Medicare. (Of that amount, Medicare paid more than $1.3 million.)

Approximately two years after the bogus claims were submitted, the article details that the company was notified of an impending audit. Investigators approached the general manager for assistance. The manager passed along the names of the investigators and their questions to the company owners so that they would be aware. When asked by the investigators if he had notified the owners of their request, the manager lied and said he had not. (He obviously was not thinking about how his cooperation might get him off on lesser charges.)

The former general manager pleaded guilty to one count each of conspiracy to commit health care fraud, conspiracy to obstruct a Medicare audit and making false statements to federal officers. He was sentenced to seven years and three months in prison plus restitution of $1,338,413. One company owner received a prison term of six years and three months, while the other one got nine years. The training supervisor was sentenced to two-and-a-half years in prison.

It is hard to tell what the consequences would have been if only the former general manager had cooperated with investigators. Instead of being honest, he chose to live a lie, hoping that his company’s fraudulent actions would not be discovered. Let’s hope he has learned the lesson that lies beget more lies and the consequences for not telling the truth always come back to get you.

Source: Today’s ”Fraud of the Day” is based on an article titled, ”FRAUD CASE: Bloomington Man Imprisoned for $5.5 Million Medicare Scam,” written by Richard Brooks and published in The Press Enterprise on February 9, 2015.

A 34-year-old Bloomington man drew a 7 1/4-year federal prison term for his role in a $5.5 million Medicare fraud, according to U.S Justice Department officials.

Wesley Harlan Kingsbury was sentenced Monday, Feb. 9, in U.S. District Court in Los Angeles after pleading guilty Sept. 15 to one count each of conspiracy to commit health care fraud, conspiracy to obstruct a Medicare audit and making false statements to federal officers.

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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.