From Fraud to Worse

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42947095 - prescription form lying on table with stethoscope, pen and pile of pills fell out from jar. medicine or pharmacy concept. tablets and recipe.

The Omaha World-Herald has the troublesome story of a woman who defrauded Medicaid of more than $200,000 by submitting false claims for mental health and substance abuse counseling. This same woman, the report states, last year struck and killed a pedestrian with her car. (The article does not make any connections between the two acts, which might be sadder still.)

According to the article, the car accident occurred because the driver was reaching for her cellphone, which had fallen to the floor of her car, when she hit a middle-aged woman who was removing items from her own vehicle’s trunk. The victim died four days later. The driver was sentenced to nine months in jail, having been found guilty of misdemeanor motor vehicle homicide.

The article does not provide details about how the woman’s fraud was uncovered, only that it occurred between 2008 and 2014, before the accident (when her need for counseling would have been obvious). In that time period, she submitted a whopping 1,599 claims. Even after the Nebraska Attorney General’s Office discovered that her claims contained falsified information around a subcontractor that did not exist and sued her for bilking the health care program out of $208,506, she went on to file a motion for a rehearing, which the presiding judge promptly denied. Instead he ordered her to pay back 150% of the money she stole. (No need to whip out your calculator; it’s $312,759 in restitution.)

Two terrible crimes: one stemming from years of deceit and the other from reckless behavior. One robbed the government and taxpayers and the other robbed an innocent woman of her life. There’s usually a bright side when fraudsters are brought to justice. But not always.

Source: Today’s ”Fraud of the Day” is based on an article titled, ”Woman who struck, killed pedestrian must pay state $300,000 for Medicaid fraud,” written by Emerson Clarridge and published by the Omaha World-Herald on March 5, 2016.

An Omaha motorist who struck and killed a pedestrian with her vehicle last year has been ordered by a judge to pay about $300,000 to the State of Nebraska because she fraudulently submitted Medicaid claims for mental health and substance abuse counseling.

Lawanda Cook, 42, submitted 1,599 claims from 2008 to 2014 to Nebraska Medicaid and a subcontractor for which no clinical records exist and was paid $208,506, the Nebraska Attorney General’s Office alleged in a civil suit.

A Lancaster County District Court judge overruled a motion for a rehearing that Cook filed and ordered Wednesday that she pay $312,759, 1½ times the amount of the claims.

Cook was sentenced in September to nine months in jail after she was found guilty of misdemeanor motor vehicle homicide.

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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.