Lying Compounds the Problem

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When you know someone is doing something illegal, lying about it is never the right response. (Lying only compounds the problem.)The owners and operators of a Mississippi-based medical supply company that also provided compounded inhalation drugs knew that billing Medicare for compounded inhalation drugs was not allowed. However, they disregarded guidelines set forth by the Centers for Medicare & Medicaid Services (CMS) anyway. (It didn’t take very long before they realized their fraudulent scheme was out of air.)

As a medical provider, the male owner of the company regularly submitted claims to Medicare for inhalation drugs that were compounded, or customized for each patient. As of July 1, 2007, CMS revised their nationwide policy regarding compounded inhalation drugs stating that any claims would be denied as not medically necessary after that time. (Despite this policy, the male owner continued to compound inhalation drugs and bill Medicare as if they were non-compounded drugs.) The woman involved in this case, who happened to be the compliance officer, knew what was going on, but she neglected to notify authorities and concealed the fraudulent billing practices.

Both 60-year-old company officials pleaded guilty for their roles in making false statements to Medicare. The man admitted to making false statements related to a health care matter. The woman admitted to committing a misprision or concealment of a felony.

At sentencing, the man faces a maximum of five years in prison, while the woman is facing three years. Both may be penalized with a $250,000 fine. Congratulations to the investigators who stopped these two fraudsters from further compounding the problem with fraud within the nation’s government health care benefit programs.

Source: Today’s ”Fraud of the Day” is based on an article entitled, ”2 plead guilty in Medicare fraud case” posted on WDAM.com on December 22, 2016.

Larry Carlton Jenkins and Annie Elizabeth Jenkins, both age 60, of Stringer, Mississippi, pled guilty on December 16, 2016, for their roles in a case involving making false statements to Medicare, announced U.S. Attorney Gregory K. Davis.

Larry Carlton Jenkins pled guilty to one count of making a false statement relating to a health care matter, while Annie Elizabeth Jenkins pled guilty to one count of committing a misprision of felony.

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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.