Check and Recheck

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Some people have a habit of checking and rechecking. Perhaps before going to bed for the night, a person might check all of the locks on their doors and windows to make sure they are secure. A student may want to go over all of his or her answers before turning in a final exam. The Bismarck Tribune reports on a man who could have avoided committing Medicaid fraud by checking and rechecking his answers on a government benefits application for his mother.

The article reports that a 65-year-old man underestimated his mother’s finances so that she could qualify for Medicaid benefits at a nursing home. The defense attorney claimed that the defendant did not intend to defraud the government on the application, but he was apparently confused about some jointly owned investments. Honest mistake or not, in this case the prosecutors only needed to prove that the man had made a false statement. (Prosecutors claimed that the son ”knowingly and willfully” checked a box labeled ”no” regarding his knowledge of his mother’s assets above the threshold for Medicaid eligibility.)

The North Dakota man’s plea agreement requires him to repay $37,000 to the government for care given to his mother. He was also assessed a civil penalty of $37,000. The judge sentenced the son to six months of probation. (This is probably a big relief because he could have gotten one year in prison, five years of probation plus restitution and fines.)

Government prosecutors generally do not go after people who make honest mistakes on government assistance applications. (After all, some of those application questions can be hard to understand.) It is not known if the son requested assistance from local government Medicaid staff when filling out the form. The lesson learned in this situation is that before signing on the dotted line the next time, this man will check and recheck the form to make sure he has given an honest and accurate answer.

Source: Today’s ”Fraud of the Day” is based on an article titled, ”Man Ordered to Pay $74,000 in Medicaid Fraud Case,” written by Dave Kolpack and published in The Bismarck Tribune on April 28, 2014.

FARGO — A North Dakota man accused of lying about his mother’s finances so she would qualify for Medicaid benefits was ordered Monday to reimburse the government for her expenses and pay a civil fine.

Authorities say Donald Hochhalter, 65, of New Leipzig, understated the value of his mother’s assets so she would qualify for government payments when she moved into a nursing home. He pleaded guilty to a misdemeanor charge of making false statements.

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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.