Home Alone

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Unless you have a clone, it is pretty hard to be in two places at once. However, an article in the St. Louis Post-Dispatch reports that a man was able to defraud an Illinois health care program by submitting false bills while serving time in prison. (That’s an interesting way to multi-task – using duplicity to deceive the government and your victims.)

The story states that the prison inmate claimed to be taking care of a patient at the time he was actually serving time in jail. He submitted fraudulent claims to the Illinois Medicaid agency, which runs a program designed to help keep beneficiaries out of nursing facilities by providing assistance with general household duties and personal care at home. (The program not only saves the state money by reducing costly health care fees, but also allows the patients to be more comfortable in their own residences.)

This fraudster is not the only one to capitalize on the home care program’s vulnerabilities. Further research revealed that a total of 43 people claiming to provide personal assistant services have been charged with fraud against the state program. (This guy was caught in the third wave of the investigation.) He faces up to 10 years in prison, a $250,000 fine and up to three years of supervised release.

This criminal, along with the other 42 defendants charged with fraud, stole money from a government program designed to help vulnerable Medicaid beneficiaries. By representing themselves as personal assistants and caregivers, they all deceived their customers and also harmed the reputations of those personal assistants who actually perform their duties correctly. (It looks like this fraudster’s days of leaving his patients home alone are over.)

Source: Today’s ”Fraud of the Day” is based on an article titled, ”Man Commits Medicaid Fraud from Illinois Jail, Court Says,” written by Blythe Bernhard and published by the St. Louis Post-Dispatch on September 5, 2014.

A man submitted claims for working in an Illinois health care program while he was incarcerated in an Illinois jail, federal prosecutors announced today.

U.S. Attorney Stephen Wigginton of the Southern District of Illinois said Christopher Spivey, 30, pleaded guilty to submitting bills to the state Medicaid agency for caring for a patient in a program aimed at keeping people in their own homes instead of nursing facilities. Spivey was incarcerated at the Richland County Jail in Olney, Ill. at the time he claimed to be taking care of the patient. A sentencing date was not announced.

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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.