Taking the Government on a Ride

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hand holding American dollar currency isolated on blurred blackground injured woman with broken hand and green cast on arm, insurance health concept.

The owners of a Columbus, Ohio medical transportation company attempted to take three government agencies on a very costly ride. But, the Medicare and Medicaid programs and the Internal Revenue Service (IRS) put a stop payment on the $3.3 million fare to cover the cost of their healthcare fraud and tax fraud schemes.

The owners of the fraudulent firm are a 67-year-old mother and her 47-year-old son. Together, they fraudulently billed federal healthcare plans for more than five years for patient medical transportation that was not eligible for reimbursement. (According to court documents, the non-ambulance trips were supposedly medically unnecessary.)

So, while they deceived both Medicaid and Medicare, they also neglected to provide accurate income amounts on their personal income tax returns. (They knew that if they stated the amount of income that they actually received from the healthcare fraud scheme, the IRS would be after them for sure. Well, here’s a newsflash – the IRS found out about their devious tax refund fraud scheme anyway.)

The mother and son fraud duo from the Columbus area pleaded guilty to healthcare fraud and tax fraud and were each sentenced to 42 months in prison for fraudulently billing the Medicaid and Medicare programs for patient trips that were not eligible for reimbursement. They were also ordered by the judge to pay more than $3.3 million in restitution to the government healthcare programs and the IRS.

This case is a perfect example of what happens when fraudsters try to take a free ride and stick the government with the bill. The justice system effectively put the brakes on these two fraud schemes that tried to degrade the integrity of the nation’s healthcare system.

Today’s “Fraud of the Day” is based on an article, “Mother, son sent to prison for falsely billing for ambulance runs,” published by The Columbus Dispatch on August 22, 2019.

The owners of a Columbus medical transportation company were each sentenced to 42 months behind bars after fraudulently billing the federal government for patient trips not eligible for reimbursement.

Jeralyn Dougherty, 67, of Dublin, and her son, Clint Green, 47, of Orient, also were ordered by Senior District Judge James L. Graham to pay more than $3.3 million in restitution to the federal Medicare and Medicaid programs and the Internal Revenue Service.

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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.