Money Talks

6

Many people have strong principles and would never dream of compromising their values when presented with an opportunity to make a lot of money through fraudulent means. Then there are others who would leap at the opportunity to make a quick buck or a million whether it was legal or not. An article published in The Des Moines Register details the story of a woman, who used her position as a former mental health official to defraud both Medicaid and private insurance companies out of $1 million.

The story states that the woman ran a counseling center that billed Medicaid and private insurers for physician visits when in reality, the mental health clients were never treated. (Court records state that one of the physicians actually lived in Pakistan. Now is that a long commute or what?)

The 47-year-old admitted to a state Medicaid investigator that her center’s billing practices were improper, but that she was oblivious that fraud was happening. (Really?) Further research revealed that several doctors shared the proceeds from the fraudulent insurance reimbursements, while others did not. Apparently, when authorities arrived at her house with a search warrant, she declared that she had never done anything wrong in her life. (Sure thing.)

In return for the fraudster pleading guilty to one count of health care fraud and one count of money-laundering, prosecutors dropped seven other charges. (Good move on her part.) She was sentenced to one year and a day in prison and ordered to pay $724,359 in restitution.The fraudster, who was formerly licensed as a nurse before running the mental health center, has proved that everyone and anything can be bought for a price. It looks like she will be nursing her own wounds obtained from her fraudulent acts while in jail. It might not hurt her to have her mental health evaluated while she is there as well. Hopefully, she’ll actually get a treatment plan, unlike any of her previous clients.

Source: Today’s ”Fraud of the Day” is based on an article titled, ”Ex-mental Health Official Sentenced to Prison for Fraud,” written by Tony Leys and published by The Des Moines Register on September 19, 2014.

The former leader of a Centerville counseling center has been sentenced to a year and a day in prison for defrauding public and private insurers out of more than $1 million.

Angela Shae Ellison admitted that she billed Medicaid and private insurers for visits with physicians even though they never treated her clients. She admitted that one of the physicians lived in Pakistan, state records have shown.

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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.