Benched

7

According to Medicaid.gov, the government health benefits program is the largest payer when it comes to mental health services in the United States. (And as you know, where there’s a large pot of money, there’s usually a fraudster or two plotting to make it theirs.) An article posted on KOLOTV.com tells how a woman used her company and her vulnerable patients to steal money from the government.

The article states that the woman at the center of this case operated a behavioral health services company in Northern Nevada called ”No Child Left Behind Behavioral Health Services” where Medicaid services to children were supposedly provided. (In reality, the woman and her company billed Medicaid for services that in many cases were never provided to her patients.)

The 39-year-old business owner was found guilty of intentional failure to maintain adequate records and her business was found guilty of submitting false claims. While the company was ordered to pay $100,000 in restitution, the judge suspended a jail sentence for the fraudster and placed her on probation for two years. During that time, she will be required to serve 200 hours of community service. (Perhaps spending a little time with the people she defrauded may be the best experience.)

This woman may have had an initial intent to help her juvenile patients when she set up her business, but somewhere along the way she became corrupt. (She not only left the children behind, but she also threw them under the bus so to speak. All for her own personal gain.) The tagline for her company implied that the business intended to work together as a team with the intention of making a difference in the community. (They made a difference alright, but unfortunately a bad one at the expense of her victims which include her patients as well as taxpayers.) Since she was not a team player in this case, she has been rightfully benched and is out of the fraud game.

Source: Today’s ”Fraud of the Day” is based on an article entitled, ”Reno owner of No Child Left Behind services guilty of fraud” posted on KOLOTV.com June 9, 2016.

RENO, Nev. (AP) – A northern Nevada company doing business as No Child Left Behind Behavioral Health Services and the 39-year-old Reno woman who owns it have been convicted of federal fraud for billing Medicaid for children’s services never provided.

Nevada Attorney General Adam Laxalt said Thursday Candia Alea Tolbert was found guilty of intentional failure to maintain adequate records, and her business guilty of submitting false claims.

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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.