What about the Victim?

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When a fraudster commits a crime against a victim, the victim is harmed and suffers a tangible loss. To help compensate victims for their loss, the Crime Victims Fund was established by the Victims of Crime Act of 1984. Fund dollars are collected from convicted criminals by U.S. Attorney’s Offices, federal courts and the Federal Bureau of Prisons. Compensation is made to or on behalf of the crime victim to cover medical or funeral costs, counseling services or lost wages. Today’s ”Fraud of the Day” from MySanAntonio.com describes a convicted fraudster who had to make a contribution to the Crime Victims Fund for his part in a conspiracy to commit health care fraud.

The man, who operated a medical supply company in California, had a habit of submitting false claims for power wheelchairs and other durable medical equipment that was not provided to Medicare beneficiaries nor was medically necessary. (In fact, the fraudster submitted more than $1.2 million in claims to Medicare through a North Dakota-based contractor, who pays Medicare claims for durable equipment suppliers throughout the State of California.) According to the story, the fraudster would frequently provide Medicare patients with less expensive electric scooters or nothing at all, while claiming that he had provided them with power wheel chairs.

After a five-day trial, the defendant pleaded guilty. The judge sentenced the 66-year-old man to one year of home confinement. He also was ordered to pay $417,811 to the contractor who processed the claim and $100,000 to the government for his fraudulent acts. And, while it wasn’t mentioned in the article, I did a little additional research and found that he also has to pay $100 to the Crime Victims Fund.

He’ll have plenty of time to think about his crime and his victims while serving his home confinement sentence. But, what about the next fraudster who commits this crime and his or her next victim(s)? Let’s start by targeting Medicare fraud up front. So, here’s the question for the day: how would you have identified this crime earlier?

Source: Today’s ”Fraud of the Day” is based on an article titled, ”Los Angeles Man Sentenced in Medicare Fraud Case,” published by MySanAntonio.com on March 3, 2014.

FARGO, N.D. (AP) — A Los Angeles man has been sentenced to home confinement and ordered to pay back more than $400,000 for filing bogus Medicare claims to Fargo-based Noridian Healthcare Solutions LLC.

Rober Ollie pleaded guilty in November to conspiracy to commit health care fraud. The plea deal came on the fifth day of a jury trial.

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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.