Benefit Buffet

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Fraudsters tend to see government benefit programs as a smorgasbord serving up an abundance of free money. A business owner, who operated six substance abuse counseling centers in Oklahoma, received more than $1.5 million in Medicaid reimbursements she did not deserve.

It is reported that the mother started the counseling center because of her daughter, who struggled with alcoholism. In an article posted on KXII.com, she stated that she wanted to go to work every day with the goal of helping people. (Technically speaking, she helped herself gain access to government benefits, not people.)

The scam was carried out by altering dates and times of service and by double-billing under variations of the same name. She submitted claims to Medicaid stating she had provided services, when she was actually on vacation, or at a wedding or a funeral. Apparently, she also hired unqualified employees.

As a result of this woman’s illegal acts, she was able to obtain $1.5 million in undeserved reimbursements before a former employee blew the whistle on her scam. (The former business owner explained that an employee signed in under her name and submitted the claims to Medicaid without her knowledge.)

The judge didn’t buy the fraudster’s explanation and ordered her to pay back more than three times the amount she stole. In all, she owes $4.7 million in restitution and fines. Another related case is pending for a woman who worked for the former counseling center owner.

This fraudster obviously wanted to feast on free benefits, but it appears her eyes were too big for her stomach. Unfortunately, she bellied up to the government benefits buffet too many times and now she has been left to pick up the check.

Source: Today’s ”Fraud of the Day” is based on an article entitled, ”Atoka business gets $4.7 million judgment for Medicaid fraud,” posted on KXII.com on August 12, 2016.

ATOKA, Okla. – Lexie Batchelor said she started LXE Counseling in Atoka in 2010 after having a daughter who struggled with alcoholism.

”I go to work every day and I try to help people,” Batchelor said.

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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.