Details, Details, Details

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When dealing with government benefits, it’s important to pay attention to the details. Because the subject of today’s ”Fraud of the Day” had a lack of attention to detail, she now has a criminal records. (That’s a detail that most people who have one don’t care to mention.)

The 51-year-old woman who provided Rehabilitative Mental Health (RMH) services to Medicaid beneficiaries in her area failed to keep accurate records. Court records show that she neglected to provide progress notes as well as time and attendance details regarding the services she provided to her clients. Over a period of five months, the woman submitted claims to Medicaid for reimbursement even though she knew she did not provide the necessary information.

The fraudster, who owned and operated her business in two separate locations, was sentenced to one count of intentional failure to maintain adequate records, which is a gross misdemeanor. (A gross misdemeanor is more serious than a misdemeanor, but less serious than a major crime.) Even though she was originally sentenced to serve one day shy of a year in jail and pay more than $15,000 in restitution, her sentence was suspended. Instead, she was placed on probation for three years. (I’d say that she was pretty lucky.)

Since most fraudsters don’t tend to work very hard when stealing government benefits they don’t deserve, it’s no surprise that this criminal didn’t put a lot of effort into her bogus Medicaid benefits claim scheme. (Even though this particular fraudster was not very detail-oriented, government investigators were and now she will definitely need to pay attention to details in order to comply with her sentence.)

Source: Today’s ”Fraud of the Day” is based on an article entitled, ”Las Vegas woman sentenced in Medicaid fraud case,” published by KTNV on August 29, 2016.

LAS VEGAS (KTNV) – Nevada Attorney General Adam Paul Laxalt announced that 51-year-old Linda Crutcher-Austin of Las Vegas was sentenced for Medicaid fraud.

The fraud was committed between June and November 2013.

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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.