Family Cover Up

18

Sometimes family members will cover for each other to prevent a loved one from getting into trouble. A father, mother and son used their family ties to abuse the Vermont Medicaid Children’s Personal Care Services Program (PCS). They stole more than $100,000 from the government benefits system that was supposed to provide services to the state’s most vulnerable citizens.

The father and mother carried out the scam by submitting claims for payment from the PCS program for services that were purportedly provided to three Medicaid beneficiaries. (They were not always provided as claimed.)The deceptive duo hired their son, other family members and an acquaintance to provide the services over a five-year timeframe. (I wonder if they were even qualified to perform those personal care services.)

Apparently, the father, mother and son kept the scam to themselves. The other family members and acquaintance were not aware that their names had been used to submit fraudulent claims to the government program. Checks were issued to the provider (the mother and the father), including the son, and mailed to the couple’s post office box. (The checks were cashed by the two and used for their own benefit.)

All three of the family members pleaded guilty to the charges against them. The father, 64, was sentenced to two to six years of imprisonment for his involvement in the scam. The amount of restitution he will need to pay will be decided at a later hearing. The mother, 43, received a suspended sentence of one to three years and was placed on probation on the condition that she perform 200 hours of community service. She must pay restitution of $28,747. Their son, 23, was convicted because he knew that the false timesheets were submitted in his name as an employee of his parents. He received a suspended sentence of one to two years and was placed on two years of probation and required to serve 100 hours of community service. The son must pay $9,329 in restitution.

This is a case where parents, who knew better, succumbed to greed and victimized their own family members and others to steal money they did not deserve. (At 23, the son was certainly old enough to make a good decision, but for whatever reason gave in to the dysfunction.) They will most likely lose their ability to participate as providers or employers in any Medicaid, Medicare or federal health care program for five years. (How about never again?)

Source: Today’s ”Fraud of the Day” is based on an article entitled, ”Bennington family convicted of multiple counts of Medicaid fraud,” published by Vermont Business Magazine on December 28, 2016.

Patrick Morse, 64, Ellie May Morse, 43, and Donald Morse, 23, of Bennington, Vermont, were convicted in Vermont Superior Court, Windsor Criminal Division, of multiple felony counts of Medicaid Fraud arising out of their scheme to defraud the Vermont Medicaid Children’s Personal Care Services (”PCS”) Program. Patrick Morse was convicted on nine counts, Ellie May Morse was convicted on six counts, and Donald Morse was convicted on three counts.
Patrick Morse and Ellie May Morse submitted claims, as the employers of record, for payments from the PCS Program, for services purportedly rendered to three recipients when those services were not actually rendered. For over five years, Patrick and Ellie May Morse falsified timesheets to document the purported services and submitted the timesheets to the PCS Program for payment.

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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.