Blowing Down Straw Houses

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As the tale of the Three Little Pigs illustrates, houses made of straw do not last very long. (Neither do businesses who try to launder illegally gained funds through straw companies.) An owner of a home health care agency who tried to bilk Medicare of more than $2.5 million had her illegal scheme involving multiple straw companies blown down by the Medicare Strike Force.

According to trial evidence, the owner of the home health agency caused millions of dollars in bogus claims to be submitted to Medicare. Over a two-month period, she oversaw the submission of 827 fraudulent claims for more than 300 Medicare beneficiaries.

The company fraudulently represented that home health services had been legitimately prescribed and provided, when in reality, they had not. (Doctors, who were listed as referring providers, stated that they had not provided any services to the beneficiaries. And by the way, those Medicare beneficiaries were not their patients either.) Approximately $2 million of the illegal payments received by the company were laundered in cash transactions involving the owner, her vice president, others and three straw companies located in Florida.

The 38-year-old company owner was convicted by a federal jury on one count each of conspiracy to commit health care fraud and wire fraud, conspiracy to commit money laundering and money laundering. She is scheduled to be sentenced.

This fraudster, who built her business on fraud, might do well to reread the popular story about The Three Little Pigs. Perhaps this time she’ll get the moral of the story – perseverance and hard work pay off in the end. It looks like this fraudster could be headed toward a more fortified and substantial structure with concrete and steel bars in the near future. (That’s what happens when you take shortcuts at the government’s expense.)

Source: Today’s ”Fraud of the Day” is based on a Department of Justice press release entitled, ”Owner of Florida Home Health Agency Convicted in Multimillion-Dollar Health Care Fraud Scheme,” released on October 7, 2016.

The owner of a Tampa, Florida, home health agency was convicted by a federal jury for her participation in a multimillion-dollar health care fraud and money laundering scheme.

Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division, U.S. Attorney A. Lee Bentley III of the Middle District of Florida, Special Agent in Charge Shimon R. Richmond of the U.S. Department of Health and Human Services-Office of Inspector General’s (HHS-OIG) Miami Regional Office and Special Agent in Charge Paul Wysopal of the FBI’s Tampa Field Office made the announcement.

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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.