FOR IMMEDIATE RELEASE:
FRIDAY - January 15, 2010
LINDEN WOMAN PLEADS
GUILTY TO HEALTH CARE FRAUD
RALEIGH - United States Attorney George E.B. Holding announced that in federal court today SANDRA ELLIOTT, 47, of Linden, North Carolina, pled guilty before United States District Judge Terrence W. Boyle to health care fraud and aiding and abetting.
A Criminal Information was filed on December 30, 2009.
In 2006 ELLIOTT opened Learning Links Educational Network Services Center, Inc. (“Learning Links”) in Fayetteville, North Carolina. Learning Links purported to provide early intervention treatment for children with developmental delays or anger management problems. When a physician ordered that a child receive mental health services or early intervention treatment, Learning Links purported to provide the services through its employees or contractors. Learning Links also purported to provide tutoring.
Learning Links primarily billed and received payments from Medicaid and Tricare, both of which are health care benefit programs. Tricare is a benefit program for military members and their dependents. Medicaid is a federally subsidized program administered by North Carolina for economically disadvantaged or disabled individuals. Through its routine billing to these programs, Elliott expanded the Learning Links operation to four locations in Fayetteville and Dunn, and was planning to open other facilities.
In 2009, law enforcement executed search warrants at all four Learning Links locations and seized all medical records and email correspondence. Through seized documents and interviews, law enforcement confirmed that Learning Links was employing non-licensed personnel, providing unwarranted therapy, and billing for services that were not rendered. Investigators learned that in some instances, the children who allegedly received services at Learning Links were not even in the state on the billed date of service. In other instances, Learning Links billed for services to children several months after they had stopped treatment at Learning Links. It was also discovered that practitioners who were no longer working for Learning Links were still being listed on Learning Links’ billing submissions as the provider of services. Moreover, some of the individuals providing services to children at Learning Links did not possess the requisite licenses for the billed services. Unlicensed services included speech and language therapy, and psychological services.
Although the exact loss is still being calculated, Elliott and the government have stipulated that the loss arising from the Learning Links health care fraud exceeds $1 Million.
The maximum penalty for the charge is up to 10 years imprisonment followed by up to three years of supervised release and a fine of up to $250,000. According to the stipulations of the Plea Agreement and in conjunction with the Forfeiture Notice included in the Criminal Information, ELLIOTT has agreed to forfeit two automobiles, a recreational vehicle, and $201,791.00, all of which have been seized.
Investigation of this case was conducted by the Defense Criminal Investigative Service, the North Carolina Department of Justice Medicaid Fraud Investigations Unit, the TRICARE Program Integrity Office, and the Health Net Federal Services Office of Program Integrity. This case is being handled by the Office’s Economic Crimes Section, with Assistant United States Attorney William M. Gilmore assigned as prosecutor.
News releases are available on the U. S. Attorney’s web page at www.usdoj.gov/usao/nce within 48 hours of release.