Medicaid fraud, one of many white collar crimes, is a serious issue, and prosecutors will typically waste no time in seeking convictions. A Georgia woman, who is the owner of the Brighter Futures Learning Center, has been arrested for insurance fraud. Authorities believe that she illegally billed over $300,000 in services that were never rendered.
Brighter Futures Learning Center provides mental health services for children and is registered with the state Medicaid program. According to reports, the owner submitted fraudulent Medicaid claims between Oct. 2010 and March 2014 resulting in white collar crimes charges. Reports suggest that she forged signatures of two contractors on falsified documents in an effort to hide her illegal activity. In addition, she reportedly obtained and used four Medicaid numbers of several contractors to send in false claims without their knowledge or consent.
The purported amount the owner claimed for and received was $355,232 for services that were never performed. The owner was charged with Medicaid fraud and forgery, as well as identity theft. She was also charged with false writings and violating the state Racketeer Influenced and Corrupt Organizations Act.
Insurance fraud is not ethical conduct, especially when a business establishment has been trusted by members in the community. However, suspicions and formal charges against someone do not mean the person is guilty of fraud. Georgia prosecutors will need to prove that the defendant knowingly and intentionally defrauded Medicaid by submitting false claims. The defendant is presumed innocent until and unless proved guilty. If evidence seems to be stacked in favor of the state, negotiations with government prosecutors may offer a means of achieving a dismissal or a plea agreement that includes reduced sentencing exposure for the defendant.
Source: Atlanta Business Chronicle, "Lithonia woman charged with taking $355K from Georgia Medicaid", , July 30, 2014
See other white collar crimes blog or this entry.