Ex-Staffing Manager Of Home Health Care Services Provider Sentenced For Alteration Of Records To Conceal Medicaid Fraud

 

Lynette Smith, 41, of Suffolk, Va., was sentenced yesterday to ten months in prison for altering records to conceal Medicaid fraud committed by a provider of home health care services. Her sentencing was announced by   Neil H. MacBride, United States Attorney for the Eastern District of Virginia, and Virginia Attorney General Ken Cuccinelli.

According to court documents, Smith, who pled guilty on July 31,  had been employed as a staffing manager by A Caring Hand Home Health Care Services, Inc. (A Caring Hand), a Virginia business owned and operated by Janice W. Holland.  A Caring Hand was authorized to provide home health care services, including respite care, to recipients of Medicaid.

From in or about January 2008 through October 2011, Holland engaged in a fraudulent scheme to obtain health care benefit payments from the Virginia Medicaid program.  Holland submitted to the program approximately 900 fraudulent claims for payment representing that respite care services had been provided to thirty (30) Medicaid recipients, when in fact no such services had actually been provided.  As a result, Holland obtained health care benefit payments totaling approximately $630,000 to which she was not entitled.

During the period from in or about September 2010 through October 6, 2011, Holland and Smith, and members of the staff of A Caring Hand at their direction, altered, falsified and made false entries in the office records of A Caring Hand to conceal and cover up the fact that Holland had submitted false and fraudulent claims for payment to the Virginia Medicaid program.   Other details about the cover up aspects can be found in the press release from the USAO.

Holland has pled guilty to health care fraud, alteration of records and aggravated identity theft, and will be sentenced on January 22, 2013.         

So 30 Medicaid patients had their information misused for this fraud scheme.  It seems that every day, around this country, Medicare and Medicaid patients are having their information misused by unscrupulous providers or others who have stolen their information.  And yet our government refuses to issue new Social Security numbers except in very rare circumstances, and it refuses to deal with the risk posed by the fact that for many, their Medicare number is also their Social Security number.

Another reason to check your explanation of benefits statements when they come in.

 

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