AGP Key in Fraud Conviction
Amerigroup Plays Key Role in Fraud Conviction
Houston Businessman Sentenced to 12 Years; Ordered to Repay $1.5 Million
VIRGINIA BEACH, Va. (Friday, January 20, 2012) – Amerigroup Corporation (NYSE: AGP) announced today the successful conclusion of a Medicaid fraud case in which the Company’s dedicated investigative unit assisted in a case where a significant amount of money will be recovered for U.S. taxpayers.
Through the operation of Logic World Medical, a durable medical equipment company, Houston businessman Benjamin Essien billed Medicaid for claims totaling more than $2.34 million and received payments for those claims, totaling nearly $1.5 million.
The Company’s dedicated investigative unit identified fraud and referred the case to the state of Texas, which resulted in last month’s sentencing of Essien. He was sentenced to 12 years in federal prison and ordered to repay nearly $1.5 million. Essien’s father and sister face sentencing later this month for their involvement in the case.
Amerigroup became involved in the case in 2005, after a member called to discuss an explanation of benefits that listed items never needed, requested or received. The Company took proactive measures and immediately conducted an investigation, which included sending a survey to other members who may or may not have received similar services from Logic World and found comparable results. The survey results and subsequent phone calls to Logic World prompted Amerigroup to turn the case over to the U.S. Attorney’s Office for the Southern District of Texas, which then opened a criminal investigation into the matter.
“This successful outcome demonstrates that we have the people, processes and technologies in place to combat fraud and ensure that our Program Integrity initiatives are working for our state and federal government partners,” said Georgia Dodds Foley, chief compliance officer for Amerigroup. “Amerigroup acts as a good steward so that healthcare dollars are spent responsibly, protecting the health and safety of our members, while safeguarding the financial stability of the Medicaid and Medicare programs.”
For further details on this case, please visit the website of the U.S. Attorney’s Office for the Southern District of Texas.
About Amerigroup Corporation
Amerigroup, a Fortune 500 Company, coordinates services for individuals in publicly funded health care programs. Currently serving approximately 2 million members in 11 states nationwide, Amerigroup expects to expand operations in 2012 to Louisiana and Washington, its 12th and 13th states, respectively, as a result of previously awarded state contracts. Amerigroup is dedicated to offering real solutions that improve health care access and quality for its members, while proactively working to reduce the overall cost of care to taxpayers. Amerigroup accepts all eligible people regardless of age, sex, race or disability.