The Definition of Greed


Fraudsters are the epitome of greed. If you opened a dictionary to the word “greed,” you would find a picture of a Youngstown, Ohio, home healthcare company owner who endangered the life of one of her clients. Her Medicaid fraud scheme left a vulnerable client unattended and robbed the government healthcare program of more than $63,000.

Today’s fraudster was the operations manager for the home health company for nearly three years. During her tenure, a client’s daughter tipped off the Ohio Department of Medicaid that her mother may be the victim of a Medicaid fraud scheme perpetrated by the company that was supposed to be caring for her. (At the time, the patient needed constant care and a breathing machine. She received neither.)

The Medicaid Fraud Control Unit audited the company’s Medicaid billings and discovered that the healthcare company neglected to provide 1,748 hours of services, yet billed Medicaid for $40,513. Investigators also found that Medicaid reimbursed the healthcare company for another $22,667 in services to the same client. (Those services were provided by an unlicensed nurse.)

The 47-year-old unlicensed nurse pleaded guilty to a misdemeanor count of theft for taking part in the scheme to defraud Medicaid. She received a suspended 180-day jail sentence and five years of probation. She was ordered to pay $5,000 in restitution to Ohio’s Department of Medicaid (ODM). At that point, ODM suspended the healthcare company’s provider agreement. (Definitely a good move.)

Fast forward to last month when the 54-year-old operations manager from Boardman, Ohio, pleaded guilty to Medicaid fraud. She received a sentence of six months in prison and three years of probation. (The fraud article states that the former operations manager has already paid back the $63,000 she cost the ODM. Fortunately, she did not cost her victim her life.)

Today’s “Fraud of the Day” is based on the article, “Boardman woman sentenced to prison for Medicaid fraud, theft,” posted on on April 18, 2019.  

COLUMBUS, Ohio – A woman who previously operated a Home Health Company in Youngstown will spend the next six months in prison, after being sentenced in court on Thursday. 

According to State Auditor Dave Yost, 54-year-old Carla Clark, of Boardman, was sentenced to six months in prison, and three years of probation for charges of Medicaid fraud and theft.

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Larry Benson is currently the Director of Strategic Alliances for Revenue Discovery and Recovery at LexisNexis Risk Solutions. In this role, Benson is responsible for developing partnerships for the tax and revenue and child support enforcement verticals. He focuses on embedded companies that have a need for third-party analytics to enhance their current offerings.