Tragic Consequences of Fraud

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According to the Federal Bureau of Investigation (FBI), healthcare fraud costs the U.S. tens of billions of dollars each year. That fact alone is terrible, but when patients are harmed because of these schemes, it is tragic. Today’s case covers the fraudulent actions of a nurse who was supposed to provide daily nursing services to a young girl with cerebral palsy. The nurse submitted bogus claims to Medicaid and received compensation for services she did not provide. Sadly, her neglect contributed to the young patient’s death. (This is not a typical “Fraud of the Day,” so grab a box of tissues.)

The former nurse in this case was hired to provide home healthcare services for the teenager who had severe physical impairments due to her condition. She required assistance with personal hygiene maintenance and feeding assistance. (She was paralyzed, unable to communicate and dependent upon feeding tubes.)

Further research revealed that Medicaid paid the nurse for care six days a week, eight hours a day. In reality, detectives determined that she only showed up at the girl’s home three to four times a month. Apparently, she did not come inside, but would honk the horn to alert the girl’s mother that she was outside. The mother would then join the nurse for shopping trips. (This is horrifying.) The evening of the young girl’s death, the nurse reported that she was in good health. (She weighed 28 pounds when she died.)

The nurse covered up her neglect by sending in false claims to Medicaid. She received payment for the bogus services over about two years even though she didn’t work the shifts that she claimed and was frequently absent from the home over extended periods of time.

The 47-year-old former nurse pleaded guilty to two counts of healthcare fraud and was sentenced to three years in prison. This sentence is on top of an involuntary manslaughter conviction and a 10-year prison sentence. (There were others involved in the conspiracy as well. Three others were also prosecuted in connection with the teenager’s death, including her mother, physician and another nurse.)

This case is a prime example that healthcare fraud is not a victim-less crime. It’s not just related to submitting fake bills and collected undeserved cash. In some cases, it is a life or death situation. This woman’s actions undermined the purpose of Medicaid, which is to provide medical care for those who are underprivileged. (While this child was deprived of the basic medical care and comfort she deserved, we can derive comfort in the fact that those who were responsible for her neglect and death, have been brought to justice for their heinous crimes.)

Source: Today’s “Fraud of the Day” is based on an article entitled, Woman sentenced in Medicaid fraud case related to a minor’s deathposted on fox45now.com on July 26, 2017.

MIDDLETOWN, Ohio (WKEF/WRGT) – A former nurse who had been convicted of involuntary manslaughter in connection with 14-year-old Makayla Norman’s death received a federal sentence for healthcare fraud Wednesday.

Mollie Parsons, 47 of Middletown, had been sentenced to service 10 years in prison for her role in Norman’s death. She had been employed as a home healthcare nurse for the girl with severe physical impairments.

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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.