A Matter of Life or Death

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52342343 - nurse taking care of sick elderly patient at home

The American Heart Association states that nearly 90 percent of people who experience a cardiac arrest while not in the hospital die. However, if Cardiopulmonary Resuscitation (CPR) is performed moments after the cardiac arrest occurs, a person’s chances of survival can double or even triple. The owner of a Louisiana-based personal care company, who provided personal care services to elderly patients, falsely claimed that his company’s employees were certified to perform CPR. (He did so in order to bill Medicaid for more than $7 million in bogus claims.)

The company, which had offices in three cities, was funded solely by Medicaid for six years. While employees assisted patients with daily activities such as bathing, grooming, dressing and eating, they were also supposed to be trained in CPR in case of an emergency. (In order to bill Medicaid for personal care services, workers must be certified in CPR. As you might guess, this company’s employees were not certified.)

The company ran into a bit of trouble when it was cited for several deficiencies during an annual survey and was subsequently required to submit a plan detailing how the problems would be fixed. (Apparently, the owner submitted the plan to the state, but lied about a few things.) The plan included bogus minutes from a board of directors meeting, a forged and fake evaluation of the company owner and another forged document stating that the company had entered into a contract with a CPR instructor.

Trial evidence showed that the company owner’s wife and her cousin helped to create 19 false American Red Cross CPR cards for the company’s personal caretakers at one of the company’s offices. (Keep in mind that these employees never attended the mandatory training necessary to meet state requirements for personal care attendants.)

The 47-year-old company owner was sentenced to 10 years in prison and must pay nearly $7 million in restitution to the state for the Medicaid fraud scheme. His 44-year-old-wife was sentenced to five years of supervised probation and must pay $54,729 in restitution plus $5,000 in fines. The woman’s 34-year-old cousin pleaded guilty to his part in the crime, was put on active supervised probation for a year and is required to reimburse the state for the cost of his prosecution. The company was also required to pay a $17,500 fine.

This company owner’s illegal scheme was dangerous and jeopardized the health and safety of his patients. While CPR certification didn’t seem to be a priority for this business owner, the government considered the situation to be a matter of life and death. (Thankfully, there were no deaths reported, but this company owner will be paying for his mistakes over the next 10 years of his life.)

Source: Today’s ”Fraud of the Day” is based on an article entitled, ”Prairieville couple sentenced in $7 million Medicaid fraud scheme,” published on December 20, 2016.

The owner of a now-defunct south Louisiana personal-care company has been ordered to spend 10 years in prison and pay nearly $7 million in restitution to the state in a Medicaid fraud scheme, a sentence that drew praise Tuesday from Louisiana Attorney General Jeff Landry.

Dwaine Joseph Woods, 47, of Prairieville, and his wife, Dynetta Hadrick Woods, 44, were convicted last year of taking part in a conspiracy to forge cardiopulmonary resuscitation and first aid training certification documents for 19 Millennium Health Care Services LLC employees who never attended training, so they would be in compliance with requirements for personal-care attendants at the time.

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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.