Taking Eligibility Too Far

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The federal government offers a plethora of assistance programs like financial aid for students, food assistance, grants and loans, programs for the military, retirement, unemployment, and welfare, just to name a few. They’ve even made it super easy to check eligibility through this website. Today’s fraudster used her son’s eligibility for Medicaid benefits to open the door to scamming the government through Medicaid fraud, Social Security fraud and Supplemental Nutrition Assistance Program (SNAP) fraud. She took eligibility too far and stole nearly $250,000 in benefits she did not deserve.

The Fredericksburg, Virginia woman at the center of today’s “Fraud of the Day” article was the mother of a disabled child who was legitimately eligible for Medicaid benefits. (The child was qualified to receive home healthcare services from attendants paid for by Medicaid.) The mother, who happened to run a daycare center, used the 11 attendants who cared for her child to assist her in her scheme.

The mother and the child’s attendants submitted timesheets to Medicaid claiming that 15,645 hours of home health services had been provided to the child over four years, costing the state of Virginia $217,519. While the attendants did provide care to her son, they also helped out with other children in the woman’s daycare center. (All funded by Medicaid dollars intended specifically for her child. That’s a great way to get cheap labor.)

She didn’t stop with the Medicaid-funded labor. She moved on to other government programs. The mother also applied for and received Supplemental Security Income (SSI) for her disabled child. The SSI program provides benefits to disabled adults and children who have limited income and resources. But, to obtain government assistance, the mother had to disclose all of her assets and income. (For two years, she did not accurately report her income, indicate she was married or reveal that she had a joint bank account with her husband. Not exactly details to leave out.) As a result, she received $14,655 in SSI benefits she did not deserve.

The third program the mother scammed was SNAP. She illegally received $14,784 in food stamp benefits from the Virginia Department of Social Services because she did not accurately report her income.

The 39-year-old Virginia woman was convicted of Medicaid fraud, Social Security fraud and Supplemental Nutrition Assistance Program (SNAP) fraud. She was sentenced to two years in prison for stealing $246,000 in government assistance over four years.

It appears that this woman took her eligibility and turned it into entitlement. The only thing she is legitimately eligible for now is time behind bars. (She definitely qualified for and earned the right to go to prison by committing these fraudulent acts.)

Today’s “Fraud of the Day” is based on an article entitled, Fredericksburg woman sentenced to 2 years for benefits fraud,” posted on WRIC.com on November 3, 2017.

RICHMOND, Va. (WRIC) — A woman from Fredericksburg was sentenced Friday to two years in prison after she was convicted of fraud.

Government officials said she made $246,000 in fraudulent Medicaid, SSI and SNAP claims from 2011 to 2015.

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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.