Recycling Patients

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52342343 - nurse taking care of sick elderly patient at home

There’s no doubt that recycling is good for the environment. It helps to reduce trash that fills landfills, uses old stuff to make new stuff, and saves money, natural resources and energy. A nurse mentioned in a Home Health Care News article took recycling to a whole new level at the home health agencies where she worked. (She tried to recycle her patients in order to illegally obtain millions in Medicare insurance reimbursements.)

The story states that the nurse, who helped run three home health care businesses located in Illinois, was one of more than a dozen people indicted for their involvement in a $45 million fraudulent Medicare scheme that transpired over six years. (The scheme claimed that Medicare beneficiaries needed the overpriced home health care, when in reality they did not.)

The nurse at the center of today’s ”Fraud of the Day” instructed other nurses to falsely certify patients for in-home skilled nursing care. She also participated in ”patient recycling” where she approved releasing patients from care, then later re-enrolled them.

Apparently, this woman’s illegal acts are just the tip of the iceberg, or patient recycling heap. The scheme also involved the company co-owners – considered to be the masterminds, a former director of nursing, a patient recruiter and several other nurses. The nurse and six others, who have pleaded guilty, are scheduled to go to trial. (While it remains to be seen what sentence this fraudster and her co-conspirators will receive for their illegal actions, it’s a sure thing that the Justice system will take into account the fact that this fraudster’s inefficient recycling efforts certainly did not save Medicare any time, money or resources.)

Source: Today’s ”Fraud of the Day” is based on an article entitled, ”Nurse Fraudster Pleads Guilty in $45 million Home Health Scheme,” published by Home Health Care News on September 14, 2016.

Following a months-long investigation of three, Illinois-based home health agencies, a nurse who helped run the companies has pleaded guilty to her role in a Medicare fraud scheme totaling $45 million, according to court documents.

Administrator and director of nursing at Donnarich Home Health Care Inc., Pathways Home Health Services LLC and Josdan Home Health Care Inc., Sharon Gulla admitted that she instructed nurses to falsely certify patients for in-home skilled nursing to reap millions in insurance reimbursements.

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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.