Mobile Fraud

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Young experienced psychotherapist making a notes

Instead of visiting a mental health provider and laying on the proverbial therapy couch, mobile therapists travel to a patient’s home, school or other location within the patient’s community to provide intensive psychotherapy services. (I’m not sure if the patients lie on their own couch or not while receiving mental health counseling. Maybe it costs less to do that.) Today, we take a look at a Philadelphia, Pennsylvania behavioral specialist and mobile therapist who committed Medicaid fraud by taking advantage of her autistic patients.

The Philadelphia-based mobile therapist engaged in fabricating timesheets that allowed her to collect $211, 942 for services she never provided to her child clients. In fact, the falsified time sheets showed that she was providing overlapping therapy services, while also working as a per-diem substitute teacher for the Philadelphia School District for more than three years. (Wow, she must be a phenomenal multi-tasker.)

The Pennsylvania therapist, who claimed to provide mental health services to autistic children in three regional health facilities, also provided bogus information on her clients’ medical records and submitted them for reimbursement, even though she never saw them. (Fake diagnoses could really mess with your mind and your ability to receive future healthcare services.) She even went as far to use a staffing agency to help carry out her ruse.

The 59-year-old mobile therapist, who worked for health providers across three Pennsylvania counties, pleaded guilty to felony charges of Medicaid fraud, theft by deception and tampering with public records. (To put it into perspective, the amount of money she collected from her scheme could pay for a two-bedroom apartment in the Philadelphia area for 18 years.) She was sentenced to one to two years in a state prison, plus six years of consecutive probation. The former therapist must also pay full restitution to multiple agencies she billed and $455 to the State of Pennsylvania for investigative costs. (Let’s just say, she is no longer mobile.)

Today’s article reveals that the former counselor used the stolen Medicaid funds to give to clients for things like groceries, stating that she just wanted to help kids and their families be in a better place. (It sounds like she wanted to be like Robin Hood, but she was simply stealing from vulnerable people to help other vulnerable people. She effectively cancelled out her fraudulent “good deed”.) Here’s hoping she can receive help that she needs while serving time.

Today’s “Fraud of the Day” is based on an article entitled, Woman gets jail time for $212G Medicaid scam,” published by Daily Times on August 8, 2018.

MEDIA COURTHOUSE >> A Philadelphia woman who defrauded Medicaid of nearly $212,000 with bogus billings for behavioral health services was sentenced to one to two years in a state prison and six years of consecutive probation Wednesday.

Delaware County Court of Common Pleas Judge John Capuzzi also ordered 59-year-old LaGracia Burnett to repay $211,942 to various agencies she had billed and $455 to the state for investigative costs.

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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.