Unqualified

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Calculator and stethoscope on paperwork

In the State of Kansas, home health care services are available to qualified seniors and individuals with disabilities who want to live independently in their homes and communities. Medical and skilled service providers help with basic personal needs such as eating, bathing, brushing teeth, administering medicine, and dressing so clients can remain in their homes. (The most important words here are “qualified” and “in their homes.”)

Gretta Elaine Smith, 52, of Wichita, submitted false claims to the Kansas Medicaid program, stating she provided in-home personal care attendant services to a qualified beneficiary, Joe Ross Mitchell, 65, also of Wichita. There are two things to note about the bogus claims: Smith did not provide any home health care services to Mitchell because he was incarcerated at the time. (Oops! Smith should have paid a little more attention to the details of her Medicaid fraud scheme before trying to steal benefits she did not deserve.) 

Between March and May 2018, Smith gladly accepted payment from Medicaid for the fake claims. She then deposited most of the “take” into Mitchell’s jail commissary account after possibly taking a cut for herself. Over approximately three months, he spent around $2,794.44 on discretionary items in the prison commissary. (That’s a little more than $900 a month. I wonder what he spent it on? Shaving cream, snacks, slippers, tableware?)

As you might suspect, both Smith and Mitchell were found guilty of Medicaid fraud. (I’m sure the large amount of money deposited in his commissary account raised a red flag.) When sentenced, it’s a good guess that Mitchell may have an extended stay behind bars coming to him, while Smith may soon be on the receiving end of judicial services. (Most likely, they will not be delivered in her home.)  

Today’s Fraud of the Day comes from an article, “Wichita woman defrauded Medicaid by claiming she was caring for a jail inmate, AG says,” published by The Wichita Eagle on February 12, 2020.

Two Wichitans have admitted to defrauding Medicaid after a woman claimed she was caring for a man who was actually in jail.

Gretta Elaine Smith, 52, pleaded guilty Tuesday in Sedgwick County District Court to one felony count of Medicaid fraud, Kansas Attorney General Derek Schmidt said in a news release. Joe Ross Mitchell, 65, pleaded guilty to the same charge last month.

 

 

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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.