Flexibility

Commentary by: Larry Benson

Today’s “Fraud of the Day” is based on an article entitled, “Beshear: Elliott County woman sentenced for Medicaid fraud,” published by The Daily Independent on October 25, 2016.

FRANKFORT Attorney General Andy Beshear and his Office of Medicaid Fraud and Abuse today announced an Elliott County woman has been sentenced on felony charges for Medicaid fraud.

Ruby Fraley, 56, of Isonville, was convicted earlier this month in Elliott Circuit Court on two counts of Medicaid fraud, both Class D felonies. Her sentencing was in Morgan Circuit Court this week, where she was sentenced to one year on each count, to run concurrent. The court probated her sentence. Additionally, Fraley paid $1,640 in restitution in advance of her sentencing.

Fake It ‘Til You Make It

Commentary by: Larry Benson

Today’s “Fraud of the Day” is based on an article entitled, “3 acquitted, 1 guilty in Medicaid fraud trial,” published by The Augusta Chronicle on November 6, 2016.

After hearing from dozens of witnesses and viewing enough records to cover the town in paper, the jury in this week’s Medicaid fraud trial acquitted the defendants of all charges except one – Carl “Tony” Wardlaw was convicted of conspiracy.
The Richmond County Superior Court jury deliberated for more than seven hours before reaching the verdicts Saturday night. Judge J. Wade Padgett imposed the maximum sentence possible for Wardlaw, five years in prison

D-I-Y Fraud

Commentary by: Larry Benson

Today’s “Fraud of the Day” is based on an article entitled, “Winstead Dentist Fined $717,046 for Illegal Medicaid Bills,” posted on ctwatchdog.com on August 10, 2016.

A Winsted dentist and his practice were ordered to pay $717,046 in restitution and civil penalties after a Superior Court judge found his conduct violated the Connecticut Unfair Trade Practices Act, also known as CUTPA, Attorney General George Jepsen said today.

The ruling, which followed an investigation and seven-day court hearing, finds that Dr. Douglas Macko and his dental practice – Douglas Macko, D.M.D., P.C. – devised and implemented an illegal scheme over several years to improperly bill the Connecticut Medicaid program for pediatric dental cleanings and fluoride treatments.

What is Medicaid Fraud?

Commentary by: Larry Benson

In honor of Fraud Awareness Week, every day this week we are providing a video of the day tied to a different government fraud related topic. Today’s video is titled, Exploring Tax Identity Theft. Watch the video and check out the related articles on this page to learn more about today’s fraud topic.

Thrown Under the Bus

Commentary by: Larry Benson

Today’s “Fraud of the Day” is based on an article entitled, “Five years in prison for Baker woman in $1 million-plus Medicaid fraud case,” published by The Advocate on August 9, 2016.

A Baker woman accused of bilking Louisiana to the tune of $1 million-plus in a Medicaid fraud scheme was sentenced Tuesday to five years in prison by a state judge who said she is one of the reasons law-abiding citizens pay higher taxes.

Even though 38-year-old Chanda Hall pleaded guilty in April to a racketeering charge, she pleaded Tuesday with District Judge Beau Higginbotham for home incarceration and insisted she “didn’t steal anything.”

No Free Rides

Commentary by: Larry Benson

Today’s “Fraud of the Day” is based on a Department of Justice press release entitled, “Co-owner of Chicago Medical Transport Company Sentenced for Fraudulent Billing Scheme,” released on August 17, 2016.

Springfield, Ill. – A Chicago woman who previously pled guilty to her role in a scheme to overbill Illinois’ Medicaid program has been sentenced. On Aug. 15, 2016, U.S. District Judge Sue E. Myerscough ordered Tina Kimbrough, 44, of Berwyn, Ill., to serve 30 months in federal prison. Kimbrough and Gregory D. Toran, 67, of Hazel Crest, Ill., owned IBT Transportation, LLC., a non-emergency medical transport company, during the period of the fraud conspiracy, from December 2005 to June 2011.

Toran was convicted of the conspiracy and seven counts of mail fraud following a bench trial before Judge Myerscough, who rendered her guilty verdicts in late July 2016. Kimbrough was also ordered to pay $4 million in restitution, due jointly and severally with Toran, who is scheduled to be sentenced on Nov. 14, 2016. Kimbrough is to self-report as directed by the federal Bureau of Prisons to begin serving her prison term.

Benefit Buffet

Commentary by: Larry Benson

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.

X-ing Out Fraud

Commentary by: Larry Benson

Today’s “Fraud of the Day” is based on an article entitled, “Milford Dentist to Pay $1.3M in Medicaid Fraud Case,” published by The Milford Patch on September 14, 2016.

MILFORD, CT — A pediatric dentist with practices in Milford and West Haven, has agreed to pay more than $1.3 million to the state and federal government to resolve allegations that uncertified assistants took X-rays of patients.

Dr. Jesus Villegas and his pediatric dental practices – Fairfield Pediatric Dentistry, LLC, in Milford and Haven Pediatric Dentistry, LLC, in West Haven – will pay $1,367,466 to resolve allegations that they violated the federal and state False Claims Acts by authorizing certain dental assistants who were not certified by the Dental Assisting National Board (DANB) to take dental X-rays of his Medicaid patients, according to authorities.

Tattle Tale

Commentary by: Larry Benson

Today’s “Fraud of the Day” is based on an article entitled, “Mother Convicted in Medicaid time-sheet fraud,” published by the Burlington Free Press on August 19, 2016.

A Swanton woman has been convicted of Medicaid fraud and ordered to serve prison time after she submitted false time sheets claiming three employees had provided personal care services to her children.

Karen Tucker pleaded guilty and was convicted of four counts of Medicaid fraud Wednesday, the Vermont Attorney General’s Office said in a statement Friday.

Official Lies Lead to Official Trouble

Commentary by: Larry Benson

Today’s “Fraud of the Day” is based on an article entitled, “Norridgewock woman sentenced for welfare fraud” posted on CentralMaine.com on July 12, 2016.

AUGUSTA — A former city woman will serve an initial four months in jail for welfare fraud involving almost $23,000 in state benefits over a 33-month period.

Nina Maraglia, 37, formerly of Augusta and now of Norridgewock, had the remainder of the two-year sentence suspended and was placed on two years’ probation.

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