More Fraud than Meets the Eye

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If criminals are successful at one scheme, they often try another. (They probably think, ”Why not maximize the return on fraud while I can get away with it?”) An article published in the Westmoreland Times tells about a physician who filed six false income tax returns. It turns out that he also submitted false medical claims to a private insurance company for services he did not provide. (As you can guess, he unjustly received reimbursement for his crime.)

The story details that the doctor filed three false individual income tax returns along with three fake corporate income tax returns over the course of three calendar years. In those fraudulent returns, he failed to disclose taxable income of $561,129 and as a result, did not pay the Internal Revenue Service $181,460 in taxes owed. Also, during two of those tax years, he submitted fraudulent health care claims to a private insurer indicating that he had provided medical services that billed at a higher rate than the services he actually performed. (Further research reveals that the doctor was busted by an undercover agent who made several visits to the doc complaining of headaches. The agent was billed for procedures that cost more than the ones he received.)

The physician pleaded guilty to filing false individual and corporate tax returns in addition to health care fraud. He faces up to 28 years in prison, a fine of $1,750,000 or both.

In this particular case, it will be up to the judge to determine the seriousness of the offenses. (It is important to note that the doctor left the country for the Dominican Republic prior to pleading guilty to tax and health care fraud. He was on the run for eight years before being arrested and brought back to the U.S.) It sounds like there was more to this fraudster than meets the eye. Let’s hope that he gets an appropriate sentence for his criminal acts.

Source: Today’s ”Fraud of the Day” is based on an article titled, ”Pennsylvania Physician Pleads Guilty to Tax Charges, Health Care Fraud,” published in the Westmoreland Times on January 19, 2015.

JOHNSTOWN, PA — A physician licensed to practice in Pennsylvania, pleaded guilty in federal court to charges of filing false individual and corporate tax returns and health care fraud, according to a statement by United States Attorney David J. Hickton. Dr. William R. Acosta pleaded guilty to seven counts before United States District Judge Kim R. Gibson.

In connection with the guilty plea, the court was advised that Acosta filed three false individual income tax returns and three false corporate income tax returns for calendar years 2001, 2002, and 2003, whereby he failed to report $561,129 in taxable income, resulting in an underpayment of $181,460 in income tax owed to the United States.

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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.