Dependent on Fraud

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health care provider

Under the Arkansas Medicaid program, the Independent Choices Program offers in-home care services to eligible beneficiaries. This program supports a more independent lifestyle by enabling participants to have a wider range of personal choice over who they hire, while offering more financial control over the services they pay for with Medicaid dollars. Today’s ”Fraud of the Day” subject was a home health care provider under the Independent Choices Program who got in trouble for billing for personal care services after she stopped providing them. (The government had no choice but to prosecute her for her illegal actions.)

The Arkansas home health care provider was originally hired to help provide daily living assistance and personal care for a Medicaid recipient. She had not worked for long when she stopped providing personal care services, but continued to submit false claims over a three-month period as if she were still working for the Medicaid beneficiary. Her reasoning for submitting the bogus claims was that she needed the money. (Don’t we all, but that’s not a reason to justify a criminal act.)

The 38-year-old woman was convicted of Medicaid fraud and was sentenced to three years of probation. She was also ordered to pay almost $1,400 in restitution to the Arkansas Medicaid Program. In addition, she must pay more than $4,000 in fines and court costs for her illegal acts. (Wouldn’t it have been easier to just provide the services?)

While the Independent Choices Program is supposed to make beneficiaries independent, it looks like this fraudster used it to become dependent on the government. Fortunately, this woman was stopped from taking advantage of this vulnerable Medicaid beneficiary and will now be held accountable for her crime.

Source: Today’s ”Fraud of the Day” is based on an article entitled, ”Phillips County woman pleads guilty to Medicaid fraud,” published by The Helena Arkansas Daily World on February 15, 2017.

A Phillips County woman was convicted of Medicaid fraud in Pulaski County Circuit Court. Arkansas Attorney General Leslie Rutledge made the announcement late Tuesday.

Jacqueline Young, 38, entered a guilty plea and was sentenced to three years probation and ordered by the court to pay almost $1,400 in restitution to the Arkansas Medicaid Program. She will also be required to pay more than $4,000 in fines and court costs, according to the attorney general.

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Larry Benson
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.