When Good Role Models Go Bad

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Positive role models are supposed to provide a good example. (They are badly needed today, especially in areas where there are disadvantaged youth.) A press release from the Commonwealth of Virginia Office of the Attorney General details the story of a positive role model gone bad. The owner and operator of a community-based mentoring program for teenage mothers victimized her residents by overbilling Medicaid by more than $80,000.

The story states that the residential program was authorized to provide services to Medicaid recipients under the age of 21. (The program was designed to help pregnant or teenage mothers complete their education and transition to independent living, while providing positive role models and a nurturing environment during the process.)

Apparently, the woman took advantage of her disadvantaged residents and submitted $81,216.08 in bogus claims to Medicaid for residential services that had supposedly been provided to 21 Medicaid recipients. (As you might guess, the services were never provided.)

The owner and operator of the program pleaded guilty to one count of health care fraud. She faces a maximum of 10 years in prison at her sentencing hearing.

The problem with role models is that they are often placed on pedestals with the highest of expectations. (The truth is that they are human and often make mistakes. That is understandable, but there was no mistake in this case – this woman intentionally preyed upon her victims.)This poor role model set her victims up to fail by not providing the counseling services they desperately needed. Fortunately, she has been stopped from causing additional harm to these at-risk teenage mothers, offering them a new chance at succeeding despite their difficult situation.

Source: Today’s ”Fraud of the Day” is based on a press release titled, ”Henrico Woman Pleads Guilty to Health Care Fraud,” released by the Commonwealth of Virginia Office of the Attorney General on March 24, 2015.

RICHMOND, Va. – Kateresea L. Ford, 42, of Glen Allen, Virginia, pleaded guilty today to one count of Health Care Fraud.

Dana J. Boente, U.S. Attorney for the Eastern District of Virginia; and Mark R. Herring, Virginia Attorney General, made the announcement after the plea was accepted by U.S. Magistrate Judge David J. Novak.

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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.