Fraudulent Friends

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Fraud is easier if there is someone on the inside that can help perpetuate a crime. An article published in the Suffolk News-Herald tells about a husband and wife team who got a little help from a Medicaid insider. Their fraudulent friend helped the duo bilk the government program out of approximately $1.3 Million.

The story states that the husband owned and operated a home health care business that provided personal care and respite services. The wife was an officer at the company. Over nearly four years, the two operated a false billing scheme where they declared they had provided services to qualified Medicaid recipients. (Yep, you guessed it. They lied.) With assistance from a former employee at the Virginia Medicaid program, the duo altered their office records including time sheets.

After a three-week trial, the 56-year-old man and his 52-year-old wife were found guilty by a federal jury of one count of conspiracy to commit health care fraud, four counts of health care fraud, eight counts of false statements, one count of alteration of records and four counts of aggravated identity theft. (I have lost count of the counts because there were so many.) They are each facing a maximum of 118 years in prison. Their partner in crime at the state agency has already pleaded guilty and is awaiting sentencing.

In the grand scheme of things, I wonder if these perpetrators are now second-guessing their decision to defraud the government. (The 118-year maximum sentence is a bit scary. Was the $1.3 million really worth spending that much time locked behind bars?) It’s a pretty sure bet that these fraudulent friends will no longer be collaborating anymore to defraud Medicaid beneficiaries of their deserved benefits.

Source: Today’s ”Fraud of the Day” is based on an article titled, ”Two Guilty of Health Care Fraud,” published by the Suffolk News-Herald on September 17, 2014.

A Medicaid provider and his wife, formerly of Suffolk, have been found guilty of health care fraud — to the tune of $1.3 million — and other charges after a three-week trial.

W. Wayne Perry Jr., 55, and Angela Perry, 52, were convicted Tuesday afternoon by a federal jury of one count of conspiracy to commit health care fraud, four counts of health care fraud, eight counts of false statements relating to health care matters, one count of alteration of records and four counts of aggravated identity theft.

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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.