When the Shoe is on the Other Foot

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The best way to experience what someone else is going through is to step into their shoes, so to speak. (That’s certainly one way to become more empathetic.) An article published by The Wichita Eagle tells about a woman who supposedly provided in-home care for low-income and disabled patients, but lied about the number of patients she was actually caring for in order to bilk the Kansas Medicaid program out of more than $40,000.

The story states that over a period of almost four-and-a-half years, the woman claimed she was a care attendant for three patients – all at the same time. (Obviously, her bills didn’t quite add up because it’s pretty difficult to be in three places at once.)

The 59-year-old pleaded no contest to one count of making false claims to Medicaid for billing the program for work she did not do. She was convicted of Medicaid fraud and was ordered to serve two years of probation and repay the Kansas Medicaid program $41,386. (If she violates the terms of her probation, she could be required to serve up to one-and-a-half years in prison.) In addition, she is not allowed to work for any government program funded by federal health care dollars. (That was definitely a good move by the judge.)

The judge also ordered the former caretaker to find a job so she could start paying back the restitution unless she was disabled due to her current battle with cancer.

This case is the sixth to be closed under an initiative called ”Operation No Show,” which is part of an effort to crack down on Medicaid billing fraud. In total, the joint initiative between the Kansas Attorney General’s Office and the Department of Health and Human Services, has ordered more than $308,000 in total restitution to be paid to the state Medicaid program.

While this woman may have been an empathetic person in the beginning, it appears she didn’t think too much about how her deceptive acts might impact those who truly deserve to receive in-home care through Medicaid benefits. Now that she is facing a long-term illness herself, it seems she may truly discover what it’s like to wear the shoe on the other foot in the near future. Let’s hope the experience makes her more empathetic and responsible as a result.

Source: Today’s ”Fraud of the Day” is based on an article titled, ”Woman Convicted of Medicaid Fraud Ordered to Repay $41,386,” written by Amy Renee Leiker and published by The Wichita Eagle on August 21, 2015.

A Wichita woman convicted of committing Medicaid fraud while she worked as a care attendant has been ordered to serve two years of probation and repay the Kansas Medicaid Program $41,386.

Joyce Ann Spencer could serve up to a year and a half in prison if she violates the terms of her probation, Sedgwick County District Court Judge Eric Yost said in handing down the ruling Friday. Spencer in July pleaded no contest to one count of making a false claim to Medicaid for billing the program for work she didn’t do between May 2009 and October 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.