New Hanover County Social Worker Pleads Guilty to Conspiring to Defraud Medicaid

RALEIGH, N.C. – Felicia Moore Jones, 52, pled guilty to conspiring to defraud North Carolina Medicaid (“Medicaid”) in a scheme that resulted in more than $400,000 in fraudulent billing.  Jones faces up to 10 years in prison and a potential fine.

“Ms. Jones’ was a social worker who was supposed to help poor Medicaid recipients get healthcare.  Instead, she stole and sold their identifying information in a scheme to bill taxpayers for care that was never provided,” said U.S. Attorney Michael Easley.  “We are fortunate to live in a generous country, where we are proud to help the less advantaged through programs like Medicaid.  But we will find and prosecute anyone who abuses that generosity for their own profit.”

According to the filed charge and information summarized in court, Jones was a social worker in New Hanover County who conspired with a licensed mental health counselor, Lakia Washington, to defraud Medicaid. Jones used her government employment to obtain personally identifying information (PII) of New Hanover County residents enrolled in Medicaid, including their Medicaid ID numbers.  In exchange for an agreed-upon fee per beneficiary, Jones then provided the PII to Washington, knowing it would be used to generate fraudulent claims for services never rendered.  Investigators have attributed over $400,000 of Washington’s fraudulent Medicaid billing to the beneficiary PII Jones provided to Washington.  Late last year, Washington pled guilty and is awaiting sentencing.  Based upon the investigation, no out-of-pocket costs were borne by the individuals whose identities were used as a part of the scheme.

“Government employees are supposed to be responsible stewards of our personal and health data, not steal it for their own profit,” said Attorney General Josh Stein. “I’m grateful to my Medicaid Investigations Division and our federal partners for their work to protect taxpayer resources and patient information.”

The Center for Medicaid Services, within the federal Department of Health and Human Services, is responsible for overseeing the Medicaid program in North Carolina, which has been administered by the North Carolina Department of Health and Human Services since 1978.  Medicaid providers are assigned a National Provider Identifier, which they use to submit claims for reimbursement for services rendered to Medicaid beneficiaries.

Michael Easley, U.S. Attorney for the Eastern District of North Carolina, made the announcement after U.S. District Judge Terrence W. Boyle accepted the plea. The U.S. Department of Health and Human Services, Office of the Inspector General, is leading the investigation with the assistance North Carolina Medicaid Investigations Division, and Assistant U.S. Attorney David G. Beraka is prosecuting the case.

Related court documents and information can be found on the website of the U.S. District Court for the Eastern District of North Carolina or on PACER by searching for Case No. 5:23-CR-00377-BO.