Lurking Fraudsters

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It’s back to school time and as children return to the classroom, it’s important to stay mindful of fraudsters who may be lurking around looking for a way to steal your child’s identity. The Federal Trade Commission reports that in 2016, 15,496 identity theft complaints were made for consumers ages 19 and under. (This amounts to four percent of all identity theft complaints for the year.) A North Carolina man, who preyed upon the children at an elementary school where he worked, is the focus of today’s “Fraud of the Day,” which involves Medicaid fraud.

There are lots of ways parents try to protect their children, like ensuring they have the best car seat available or making them wear bike helmets. In this day and age, it’s important to also be vigilant about protecting kids from things that cannot be seen. (This includes criminals who covertly use their identities to steal money or government benefits.)

Because a child does not typically use their Social Security number (SSN) until they become adults, the probability of discovering identity fraud is minimal because most parents don’t monitor their children’s identities. (After you read about today’s story, you’ll be encouraged to put a plan in action to do so.)

Today’s criminal is a licensed professional counselor who owned and operated a counseling business in Tryon, NC. He was a Medicaid-approved provider of mental and behavioral health sciences while also employed as a guidance counselor at a local elementary school. (Let’s just clarify that guidance counselors are supposed to help students with their academics, as well as their personal and social development. That’s not what this guy had in mind.)

The counselor systematically identified his victims at the elementary school, which included students and their siblings. He then accessed their personal information for the purpose of creating and submitting bogus bills to Medicaid for individual psychotherapy services. (One important fact to note – those services he claimed were never rendered.) Over the course of the scheme, he submitted more than $450,000 in fake claims and as a result, collected $436,229 in illegal reimbursements. (Court documents show that those reimbursements were deposited into bank accounts he controlled.)

The 46-year-old North Carolina school counselor pleaded guilty to committing healthcare fraud over a three-year period. This criminal’s sentencing date has not yet been set, but when he finally faces the judge, he will be looking at a maximum of 10 years in prison and fines up to $250,000.

This deceptive counselor abused his position as a school system employee to manipulate the personal information of vulnerable children just so he could line his pockets with money stolen from a government program. (How would you feel if your child was subject to someone like this on a daily basis in an environment where they are supposed to feel safe?) Fortunately, he has been stopped from lurking around other potential victims for now. (Let’s hope the sentence he receives will help him to learn this important lesson – the government doesn’t fear criminals who lurk in the shadows and will do anything possible to expose and properly prosecute them for Medicaid fraud.)

Today’s “Fraud of the Day” is based on an article entitled, NC school counselor pleads guilty to health care fraudposted on WSPA.com.

ASHEVILLE, N.C. (WSPA) – A school counselor has admitted to committing health care fraud of over $400,000, according to a news release.

46-year-old Joseph Frank Korzelius pleaded guilty to one count of health care fraud after he submitted false reimbursement claims that defrauded the North Carolina Medicaid Program of over $400,000.

 

 

 

 

 

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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.