Permission Slip for Fraud

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Permission slips come in different forms. Schools require them so that children can visit the local zoo on their class trip. Doctors request a signature from a patient getting the flu shot stating there are no allergies to the vaccine about to be administered. An article published in The Boston Globe details how a job applicant’s personal information was used without her permission to bill government agencies for services that she did not provide as a psychologist.

The story states that a set of twin sisters ran two separate mental health services companies that provided psychological exams. They are accused of billing Medicaid and Medicare for more than $490,000; the University of Massachusetts Medical School for $30,000 in disability evaluations; and a local Massachusetts public school system for more than $60,000 in psychological evaluations for special-needs students.

Authorities say these two women allegedly carried out the scheme by stealing and using the personal identification information of multiple victims, who happened to be legitimate psychologists. (One psychologist provided her personal identification information while considering a job opportunity at one of the mental health companies.) The two women purportedly provided mental health services to clients despite the fact they were not licensed to do so, and allegedly netted more than $580,000 from federal and state agencies.

The two are currently facing charges including submitting false Medicaid claims, false claims to a public agency, larceny, identity fraud and the unlicensed practice of psychology. The sisters have been arraigned and have pleaded ‘not guilty’ to the charges.

It is important to remember that the 49-year-old twins are innocent until proven guilty. Regardless of the outcome, the case is instructive because the claims made by prosecutors about stolen personal identity information being used for fraudulent purposes apply to nearly any government benefits fraud scenario. We have all provided our personal information hundreds of times – in doctor’s offices, at school, in housing rental applications, or job applications…just to name a few. It’s time to start asking how that information is being protected in the locations where we are providing them and by the government agencies that are processing identity information.

Source: Today’s ”Fraud of the Day” is based on an article titled, ”Twin Sisters Charged in Medical Fraud Case,” written by Travis Anderson and published in The Boston Globe on September 16, 2014.

Twin sisters who used to live in Burlington will be arraigned Tuesday on charges of stealing more than $580,000 from state and federal agencies in an alleged scheme that involved identity fraud and conducting unlicensed psychological exams, prosecutors said.

The sisters, Nita Guzman and Nina Tischer, both 49, provided mental health services between 2008 and 2012 through two companies that they ran, but the siblings were not licensed psychologists, Attorney General Martha Coakley’s office said.

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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.