A Need for Respite

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26578311 - male nurse pushing stretcher gurney bed in hospital corridor with male & female doctors & nurses & senior female patient in a wheelchair

Everyone needs a break at some point, especially primary caregivers of people who cannot care for themselves. This duty often falls on the shoulders of family members, who can become exhausted by their efforts. When some periodic relief is needed, a home health care company that provides respite care can be hired to provide temporary care for a loved one. An article in the Richmond Times-Dispatch tells about the owner of a Suffolk-based respite care business who took advantage of Medicaid recipients by billing for services her company never provided. (Home health care is often a target for fraud.)

The story states that the owner of the home health company filed approximately 385 false claims with the Virginia Medicaid program over a four-year period, representing services that were never rendered to 38 Medicaid beneficiaries. Medicaid paid her $294,713 for the false claims. (That averages $765 per claim.)

The 57-year-old woman pleaded guilty to healthcare fraud and was sentenced to two years and nine months in prison.

Caring for an ill relative can put an enormous amount of pressure on family members and other relatives who want to provide a caring environment for their ill loved one. Taking advantage of Medicaid recipients who deserve and have earned the right for respite care is a heinous crime. This fraudster scammed deserving beneficiaries so that she could line her pockets with money she didn’t work for nor deserve. In this case, however, the woman does deserve the prison sentence that she has received.

Source: Today’s ”Fraud of the Day” is based on an article titled, ”Suffolk Woman Gets 33 Months for Medicaid Fraud,” published by the Richmond Times-Dispatch on June 14, 2014.

NORFOLK — A Suffolk home health care services provider who pleaded guilty to defrauding Medicaid has been sentenced to nearly three years in prison.

Fifty-eight-year-old Angie L. Gilchrist was sentenced Thursday in federal court in Norfolk to two years and nine months for health care fraud.

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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.