Former Ellsinore man pleads guilty to healthcare fraud - KFVS12 News & Weather Cape Girardeau, Carbondale, Poplar Bluff

Former Ellsinore man pleads guilty to healthcare fraud

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CAPE GIRARDEAU, MO (KFVS) - A former Ellsinore man pleaded guilty to falsely claiming that he needed and received home care.

Gary Wayne Bender, 47, formerly of Ellsinore lived next door to a home care provider in Ellsinore which provided in-home health and personal care services.

To be eligible for the services, patients must need in-home services in order to remain in their homes.

Bender agreed to sign time sheets to falsely indicate he had received in-home services, according to the United States Attorney's Office Eastern District of Missouri.

According to the plea agreement, from 2008 to 2011, Bender and others devised a fraud scheme to obtain Medicaid reimbursement for in-home services that were never rendered.

Bender was able to drive, mow lawns, do construction and painting work while claiming to need in-home services to avoid placement in a nursing home.

Bender was told to "act dumb" when anyone attempted to assess his eligibility for in-home services, according to the plea agreement.

Around 2010, Bender entered into an agreement to sign time sheets falsely indicating he had received in-home services, according to plea agreement.

Time sheets were created indicating Bender received assistance with dressing and grooming, bathing and personal hygiene, toileting and continence, and mobility and transfer, but noon of the services were needed or provided, according to the plea agreement.

From May 2010 to about April 2011, Medicaid paid the home care provider almost $15,000 for in-home services that were never provided to Bender, according to the plea agreement.

Also according to the plea agreement, Bender submitted a reimbursement claim for in-home services that were never provided to him on Oct. 4, 2010.

Bender is accused of splitting the payments with someone with connections to the home health provider, according to the plea agreement.

Bender now lives in Tennessee, according to the United States Attorney's Office Eastern District of Missouri. His sentencing has been set for June 9, 2014.

This charge carries a maximum penalty of ten years in prison and/or fines up to $250,000.

Endeavor Home Care released the following statement:
"Endeavor Home Care is a licensed provider of in-home care and service. We are subject to regular audits by the State of Missouri and consistently satisfy those audits. When a client applies for our services, they are interviewed by a certified worker employed by the state. We rely upon the findings of the state workers before providing care. Mr. Bender went through that process, following a personal interview with a state worker. He was approved by the state to receive our services. Mr. Bender consistently told us that he was receiving the services he was supposed to receive, in the years 2010 and 2011. If Mr. Bender committed fraud, he did so without our knowledge and certainly without our involvement. Any Medicaid reimbursements that were made were made consistent with the care Mr. Bender received. Neither Endeavor nor any of its owners or employees paid Mr. Bender for any of his alleged criminal acts. Endeavor makes every effort to verify that its clients are receiving the care they are entitled to. It is unfortunate that Mr. Bender and his plea agreement imply that Endeavor had anything to do with Mr. Bender's alleged criminal acts. We continue to offer our services to those in need and provide much-needed assistance and aid to those who are entitled to receive government benefits."

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