Jamaican Me Crazy

19

Fraudsters love to spend their stolen money on lavish lifestyles, expensive vehicles, luxurious designer items and trips to warm climates ,preferably islands where they cannot be easily found. A former mental health counselor from Pennsylvania used Medicaid to fund at least 24 trips out of the U.S., mostly to Jamaica.

The former owner of the counseling business billed Medicaid for more than $100,000 in mental health services he never provided. One of his former employee ‘s, who set up the system he used to electronically bill the Medicaid program, blew the whistle on her boss when she realized that he was a master manipulator. (The claims he submitted had many discrepancies between the number of hours he billed for and the amount he charged for services he did not provide.)

One of his patients testified that they often ran personal errands for the counselor including picking up his mail and driving him to the airport in the middle of the night. He told her he was visiting Jamaica to check on his family business and was considering a move out of the U.S. (Apparently, he told her he could also provide counseling services for her while she drove him around, but instead, he was talking to other women on the phone during that time. Call me crazy, but that ‘s just ridiculous.) Other patients, when presented with the fraudulent billing claims, verified that the counselor ‘s bills were incorrect.

When standing before the court, the 56-year-old requested leniency and blamed his poor choices on stress related to addiction, depression and multiple deaths within his family. He also explained that it was hard to live with the embarrassment that he had brought on his family and requested a county jail sentence so that he could be close to his young daughter. (He should have thought about that before he decided to commit the fraud.)

The former counselor was sentenced to two years and four months to five years in state prison after pleading guilty to Medicaid fraud that occurred over four years. The judge surmised that this case came down to greed and the desire to live a lifestyle that was not affordable. (Let ‘s hope that this former counselor can receive some good advice while serving out his time behind bars.)

Source: Today’s “Fraud of the Day” is based on an article entitled, “Counselor sentenced in Brodheadsville Medicaid fraud,” published by The Pocono Record on February 4, 2017.

Michael Johnston, 56, former owner/operator of Vision Counseling Services in Brodheadsville, was sentenced Thursday to two years and four months to five years in state prison after pleading guilty in a Medicaid insurance billing fraud case.

Johnston pleaded guilty to billing his patients’ insurance provider more than $100,000 for mental health services he never provided to the patients. He used that money to cover trips to Jamaica and other personal expenses, the state Attorney General’s Office learned.

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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.