Healthcare Compliance Perspective – Fraud:
Under the HIPAA privacy rule a nursing home is required to protect the “individually identifiable health information” it maintains regarding its residents. This information includes common identifiers such as name, address, birthdate and Social Security Number. The Privacy Officer of a nursing home may want to help make residents and their family members aware of the potential for identity theft and the possible theft of payments a resident may regularly receive from the government and other sources.
A man from Lowndes County Georgia will go to federal prison for five years for his role in a scheme where he and other conspirators used illegally obtained identities of nursing home residents, state prisoners and others to file “fraudulent income tax returns.” The accused man pleaded guilty to charges in January that included conspiring to “embezzle public monies and possess stolen U.S. Treasure checks.”
According to the U.S. Attorney for the Middle District of Georgia, in 2010 the man and his co-conspirators filed 102 fraudulent returns and claimed about $450,00 in refunds. He received about $300,000 from the claimed refunds. The next year, 2011, the man and his co-conspirators significantly increased the number of fraudulent returns they filed to 432 returns for a total of over $3.7 million. Out of these they received $1,185,259 in refunds from those fraudulent returns.
Using direct deposit options allowed by the IRS, the fraudulently obtained refunds were deposited into numerous accounts for different people in multiple banks. Debit cards were also used to access refunded amounts.
The man also admitted that in 2013 he used a bank account to knowingly convert stolen U.S. Treasury checks and fraudulently obtained tax returns into cash. Most of the checks he cashed were from fraudulent tax returns, but he also illegally obtained and cashed Social Security checks and Thrift Savings Plan payments.
Altogether, the man and his co-conspirators are believed to have stolen more than $4.7 million from the U.S. Government. Along with his prison sentence, the government is demanding $2 million be paid back as restitution.
