Culture Shock or Shocking Fraud?

Commentary by: Larry Benson

Today’s “Fraud of the Day” is based on an article titled, “Woman guilty of one of the biggest cases of benefits fraud in the Bronx avoids jail after paying back $85k,” written by Ben Kochman and published by The New York Daily News on Oct. 20, 2015.

She bilked the city out of thousands — and paid big.

A Bronx woman who committed one of the borough’s biggest ever case of benefits fraud got off with five years’ probation Tuesday after paying back a hefty chunk of cash.

Parvattie Raghunandan, a Guyanese immigrant who misrepresented her family’s income for a decade — netting thousands in fraudulent Medicaid payments — received the jail-less sentence in Bronx Supreme Court after paying back over $85,000 and pleading guilty to grand larceny.

No Work, No Pay

Commentary by: Larry Benson

Today’s “Fraud of the Day” is based on an article titled, “Iola man ordered to repay $7,000 for Medicaid fraud,” written by News Release and published by KOAM-TV on Nov. 4, 2015.

An Iola man was ordered today to repay $7,000 to the Kansas Medicaid Program after pleading guilty to Medicaid fraud-related charges, Kansas Attorney General Derek Schmidt said.

Kim Alan Laymon, 53, pleaded guilty in September in Neosho County District Court to one count of theft. Judge Daryl Ahlquist today ordered Laymon to repay $7,000 to the Kansas Medicaid Program. Judge Ahlquist also sentenced Laymon to 12 months probation with an underlying sentence of seven months in prison. Convictions such as this one also result in a period during which the defendant is prohibited from being paid wages through a government health care program.

All Aboard the Fraud Train

Commentary by: Larry Benson

The article states that this case was part of the largest crackdown ever on health care fraud in the District of Columbia. As a result, more than 25 others have been charged in separate cases. Congratulations to the investigators and prosecutors in this case for derailing this couple’s fraudulent itinerary.

Today’s “Fraud of the Day” is based on an article titled, “Federal jury convicts MD. couple in $80 million D.C. Medicaid fraud case,” written by Spencer S. Hsu and published by The Washington Post on Nov. 12, 2015.

A federal jury on Thursday convicted a Bowie, Md., couple of orchestrating a multi-year campaign to defraud D.C. Medicaid of more than $80 million between 2009 and 2014, the largest local health-care fraud scheme ever prosecuted in the city.

After a four-week trial in federal district court in the District, the jury deliberated two days before convicting Florence Bikundi, 52, of four counts of health-care and Medicaid fraud and conspiracy, and her husband, Michael D. Bikundi Sr., 63, of two counts of fraud and conspiracy through her company, Global Health Care Services of the District.

Physical Therapy, Occupational Fraud

Commentary by: Larry Benson

Today’s “Fraud of the Day” is based on an article titled, “Clinic owner pleads guilty in $55 million fraud,” written by Dan Goldberg and published by Capital New York on October 26, 2015.

A 46-year-old woman who owned two Brooklyn medical clinics pleaded guilty Monday to defrauding Medicare and Medicaid out of $55 million, according to a press release from the U.S. Attorney’s office.

Valentina Kovalienko will pay back nearly $30 million after admitting she was part of a scheme that paid patients to undergo medically unnecessary physical and occupational therapy, which was performed by unlicensed professionals.

The services were billed to Medicare and Medicaid and the patients would receive a kickback, the release said.

The Apple Doesn’t Fall far From the Tree

Commentary by: Larry Benson

Today’s “Fraud of the Day” is based on an article titled, “Richmond Heights woman sentenced for healthcare fraud,” and published by on October 15, 2015.

CLEVELAND — A Richmond Heights woman will spend nearly 8 years in prison for operating an $18 million home health care fraud scheme.

Sharon Ward, 45, was sentenced to 94 months in prison and ordered to pay $18 million in restitution after being found guilty of health care fraud and aggravated identity theft.

When the Fraud Hits the Fan

Commentary by: Larry Benson

Today’s “Fraud of the Day” is based on an article titled, “Brighton woman pleads guilty to healthcare fraud,” and published by The Alton Telegraph on October 15, 2015.

Brighton Woman Pleads Guilty To Healthcare Fraud Offense
BRIGHTON —A Brighton woman has pleaded guilty to federal healthcare fraud charges, submitting fake bills to a Medicaid waiver program as a personal assistant. She also admitted to neglecting one of her customers.
U.S. State’s Attorney Stephen R. Wigginton announced Thursday that Jessica A. Teets, 27, of Brighton, pleaded guilty in the U.S. District Court on Tuesday to the charge that she engaged in a scheme to defraud a health care program.
Sentencing has been set for Feb. 9, 2016, in East Saint Louis. Teets will face up to 10 years in prison, a fine of up to $250,000, and up to three years of supervised release.

No Laughing Matter

Commentary by: Larry Benson

Today’s “Fraud of the Day” is based on an article titled, “Woman receives 5-year sentence for welfare fraud,” written by Ron Wilkins and published by the Lafayette Journal & Courier on September 24, 2015.

Tramillia Ruth Benson-Lewis admitted to welfare fraud last month, and Thursday Tippecanoe Superior 1 Judge Randy Williams sentenced her to 5 years.
Benson-Lewis, 33, of Lafayette, will serve two years under the supervision of the Tippecanoe County Community Correction. Williams suspended three years of the sentence, but she will be on probation during that time.

Gambling with Fraud

Commentary by: Larry Benson

Today’s “Fraud of the Day” is based on an article titled, “Lincoln pharmacist pleads guilty to possibly state’s biggest Medicaid fraud,” written by Lori Pilger and published by the Lincoln on September 30, 2015.

A Lincoln pharmacist tearfully pleaded guilty Tuesday to health care fraud, admitting he bilked Nebraska’s Medicaid program of $14.4 million in what is believed to be the largest such fraud on record in the state.
Federal prosecutors say Scott Tran, owner of Tran Pharmacy at 2655 S. 70th St., submitted hundreds of claims for TOBI, a tobramycin solution used in inhalers for cystic fibrosis patients, in the names of his customers’ children.

Read the Fine Print

Commentary by: Larry Benson

Today’s “Fraud of the Day” is based on an article entitled “Pines Woman Take Plea Deal in Medicaid Fraud Case,” written by Wayne K. Roustan and published by the Sun-Sentinel on September 17, 2015.

A Pembroke Pines woman has pleaded guilty to accepting bribes as part of a nearly $3-million health care fraud scheme, federal court records show.

Maria Sanchez, 50, of Pembroke Pines, struck a deal with government attorneys Tuesday and is facing up to five years in prison and $250,000 in fines when sentenced at a later date, the records indicate.

When the Shoe is on the Other Foot

Commentary by: Larry Benson

Today’s “Fraud of the Day” is based on an article titled, “Woman Convicted of Medicaid Fraud Ordered to Repay $41,386,” written by Amy Renee Leiker and published by The Wichita Eagle on August 21, 2015.

A Wichita woman convicted of committing Medicaid fraud while she worked as a care attendant has been ordered to serve two years of probation and repay the Kansas Medicaid Program $41,386.

Joyce Ann Spencer could serve up to a year and a half in prison if she violates the terms of her probation, Sedgwick County District Court Judge Eric Yost said in handing down the ruling Friday. Spencer in July pleaded no contest to one count of making a false claim to Medicaid for billing the program for work she didn’t do between May 2009 and October 2013.

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