Nurse Practitioner Admits to Receiving Kickbacks for Signing Orders for Medicaid Services
RALEIGH – The United States Attorney Office for the Eastern District of North Carolina, John Stuart Bruce, announced that today in federal court, CHRISTINE HICKS THOMAS, 62, of Murfreesboro, North Carolina, pleaded guilty to Illegal Remunerations. Under the terms of the plea agreement, THOMAS faces up to 5 years in prison, $25,000 in fines, and 3 years of supervised release. Under additional terms discussed in court, THOMAS agreed to surrender her nursing license, to surrender any interest she has in companies that bill the government for health care services, and to be permanently excluded from Medicare and Medicaid programs.
According to the Criminal Information and evidence discussed in open court, THOMAS, a licensed nurse practitioner, agreed to sign off on orders authorizing various Medicaid recipients to receive outpatient behavioral health services. In fact, THOMAS never evaluated the patients or made any clinical assessment of whether the services were medically necessary for the recipients. In a recorded encounter in a parking lot, THOMAS accepted a cashier’s check in exchange for signing the orders.
The orders that THOMAS signed are required by Medicaid’s Managed Care Organizations as a prerequisite before a Medicaid provider can bill the government for outpatient behavioral health services. Once authorization orders are signed, providers can lawfully bill the government for hundreds of thousands of dollars in outpatient behavioral health services, provided such services are actually rendered.
As a result of her conviction and plea, THOMAS will no longer be a licensed nurse practitioner, and will no longer be able to participate in government health care benefit programs such as Medicare and Medicaid. She will also face a potential sentence of imprisonment.
This case is part of a broader investigation of a Medicaid fraud conspiracy carried out by Terry Lamont Speller; Donnie Lee Phillips, II; and Reginald Saunders, whose cases have already been sentenced. The investigation also relates to the pending case against Shephard Lee Spruill, II. Each of these cases are the subject of prior press releases.
The investigation of this case was conducted by agents of the North Carolina State Bureau of Investigation assigned to the Medicaid Investigations Division of the North Carolina Attorney General’s Office; The Internal Revenue Service - Criminal Investigation; and the United States Department of Health and Human Services Office of the Inspector General, with the assistance of the Federal Bureau of Investigation. The investigation and prosecution of this matter is being handled in a partnership between the United States Attorney’s Office for the Eastern District of North Carolina and the Medicaid Investigations Division of the North Carolina Attorney General’s Office. Assistant United States Attorney William M. Gilmore of the Economic Crimes Division, and Special Assistant United States Attorney Daniel Spillman of the Medicaid Investigations Division of the North Carolina Attorney General’s Office, each represented the United States.
If you suspect Medicaid or Medicare fraud please visit the HHS OIG website at https://oig.hhs.gov/ and click on the Report Fraud button. To report Medicaid fraud in North Carolina, call the North Carolina Medicaid Investigations Division at 919-881-2320.