Here at AMG-SIU we come across interesting cases of fraud, waste and abuse all the time – but today, we came across fraud from a completely different source – the news.

Today it was reported that a man committed identity theft from a Medicaid patient to receive heart bypass surgery. Typically when you see someone steal an identity for medical benefits – it’s a one-time event: not for John Parsons. Parsons repeatedly committed fraud to secure a heart bypass surgery.

I’m probably wondering the same thing you are – how did he do this?

According to initial reports, it was not the internal or external vendors who caught the fraud: it was the caregiver of the man whose identity was stolen, Philip Johnson. Our own solution reports when any permanent characteristic is inconsistent with what we have on file such as birth date, sex, height and so forth – so we’ll be watching this story closely to make sure our own solution is capable of finding this type of fraud.

AMG-SIU’s very own COO Lori Lewis and the Director of Regulatory Affairs Barbara Lamberson, CFE will be attending the 24^th annual NAMPI conference next week in Williamsburg, VA. 

For those of you who are unfamiliar, the National Association of Medicaid Program Integrity (NAMPI) conference provides states with a venue to share information about their Medicaid programs and help each other prevent fraud, waste and abuse.  

If you’re attending and see Lori or Barbara around the conference, please stop and say hi!