Raleigh Residents Sentenced for Health Care Fraud Conspiracy Targeting North Carolina Medicaid
RALEIGH – Robert J. Higdon, Jr., the United States Attorney for the Eastern District of North Carolina, announces that yesterday in Federal court in New Bern, United States District Judge Louise W. Flanagan sentenced CHRISTOPHER LEON BROWN and MARK RAYFIELD BROWN, JR., both of Raleigh, North Carolina to 40 months in prison and 30 months in prison, respectively, for their roles in a health care fraud conspiracy that targeted the North Carolina Medicaid system. The Court ordered the terms of imprisonment to be followed by three years of supervised release. Both defendants were also ordered to pay restitution to the North Carolina Medicaid Program, among other terms of the judgment.
CHRISTOPHER LEON BROWN was named in Criminal Information filed on March 31, 2017, which charged him with conspiracy to commit health care fraud. On April 13, 2017, BROWN pled guilty to the charge.
MARK RAYFIELD BROWN, JR. was named in a Criminal Information filed on December 22, 2016, which charged him with conspiracy to commit health care fraud. On February 16, 2017, BROWN, JR. pled guilty to the charge.
A third co-conspirator, DARRYL VASHAUN STANFORD, of Raleigh, North Carolina, pleaded guilty to a Criminal Information on April 13, 2017. On February 22, 2018, STANFORD was sentenced to 34 months imprisonment and three years of supervised release and ordered to pay restitution to North Carolina Medicaid Program, among other terms of the judgment.
According to the charging instruments, statements made in court, and other public information, BROWN, BROWN JR., and STANFORD were co-conspirators in a health care fraud scheme that stole hundreds of thousands in funds from the North Carolina Medicaid Program through the purchase and exploitation of stolen Medicaid beneficiary information and clinician information. The stolen information was used by the co-conspirators to submit thousands of false and fraudulent claims for reimbursement for health care services that were never rendered by the listed providers. The co-conspirators targeted the North Carolina Health Choice (NCHC) Health Insurance Program for Children in particular, a comprehensive health coverage program for low-income children which is part of the North Carolina Medicaid system.
Between approximately April 2014 and May 2015, BROWN, BROWN, JR., and STANFORD submitted fraudulent claims to Medicaid through Christian Medical Center, Inc., a purported provider of outpatient behavioral services in eastern North Carolina. In truth, Christian Medical was a shell company or “false front” with no legitimate business operations by this point. BROWN, JR. was the owner of record for Christian Medical and partnered with BROWN (no relation) to facilitate the scheme. Among other things, BROWN purchased stolen Medicaid beneficiary information and forwarded it to STANFORD, an experienced Medicaid biller. STANFORD, in turn, used the stolen information to prepare and electronically file the fraudulent claims on Christian Medical’s behalf through Medicaid’s NCTracks system.
In addition to their roles with respect to the Christian Medical scheme, BROWN and STANFORD were charged with, pleaded guilty to, and sentenced for engaging in a related conspiracy to file thousands of fraudulent Medicaid claims on behalf of multiple other providers. These claims also incorporated stolen Medicaid beneficiary information and clinician information.
Investigation of this case was conducted by the Federal Bureau of Investigation and the North Carolina Department of Justice, Medicaid Investigations Division. Assistant United States Attorney Adam F. Hulbig prosecuted the case for the government.