Breach of Trust

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Man giving bribe to a doctor

A Bridgeport, Conn., woman is spending the holidays behind bars and will have to pay more than $1.3 million for her role in an identity theft scheme that defrauded the Medicaid and Social Security benefits programs.

The 46-year-old reported to prison in September and will be released after serving a seven-month sentence. (That sounds like a light sentence, although she’ll have a lot of work ahead of her to pay off $1,369,654 in restitution.)

The woman was a substance abuse healthcare provider when she was approached by the owner of two businesses that provided social and psychotherapy services. At the business owner’s suggestion, the healthcare provider began stealing the personal information of Medicaid recipients who were patients at her clinic. (That’s quite a breach of trust). Using the stolen Medicaid ID and Social Security numbers and dates of birth, the two, and another woman, billed Medicaid for services that were not rendered.

The 46-year-old healthcare provider pleaded guilty to one charge of healthcare fraud and another charge of aggravated identity theft. She admitted that they stole the identities of more than 150 Medicaid clients and that she and her co-conspirators successfully billed Medicaid for about half of those clients.

The other two women also pleaded guilty to one count each of healthcare fraud and a separate charge of Medicaid fraud. The woman who owned the two businesses was also an employee of the Connecticut Department of Mental Health and Addiction Services. She was sentenced to two years in prison and ordered to pay restitution of $2.5 million. The third woman was sentenced to a year in prison and ordered to pay $2.7 million in restitution.

But that’s not all for these three from Connecticut – each were convicted, along with five other people, in separate charges of healthcare and childcare benefits fraud as part of this investigation. (Imagine if they’d put as much effort into helping patients as they did to committing fraud).

People who suspect healthcare fraud are encouraged to report it by calling 1-800-HHS-TIPS.

Today’s Fraud of the Day is based on a Department of Justice press release, “Bridgeport Woman Sentenced to Prison for Identity Theft, Health Care Fraud Offenses,” issued by the U.S. Attorney’s Office for the District of Connecticut on July 12, 2019.

John H. Durham, United States Attorney for the District of Connecticut, announced that NIKKITA CHESNEY, 46, of Bridgeport, was sentenced today by U.S. District Judge Victor A. Bolden in Bridgeport to seven months of imprisonment, followed by three years of supervised release, for her role in a Medicaid fraud scheme.

According to court documents and statements made in court, in May 2012, Chesney was employed by a health care provider that provided substance abuse treatment, including a detoxification program located in Bridgeport, when she was approached by Toshirea Jackson. Jackson and Juliet Jacob operated two businesses, Transitional Development And Training (TDAT) and It Takes A Promise (ITAP), both located at 360 Fairfield Avenue in Bridgeport, which provided social and psychotherapy services.  At Jackson’s suggestion, Chesney began to steal the personal identification information of Medicaid clients who were patients of her employer.  The personal identifying information included the patients’ Medicaid identification number, Social Security Numbers and dates of birth. Chesney, Jackson and Jacob then used the stolen identity information to bill Medicaid for psychotherapy services purportedly provided by TDAT and ITAP, when the Medicaid clients had never received any such services from TDAT and ITAP.

 

 

 

 

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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.