Two Behavioral Health Clinic Operators Plead Guilty To Conspiracy To Commit Over $1 Million In Health Care Fraud
Jacksonville, FL – Acting United States Attorney W. Stephen Muldrow announces that Shawn Thorpe (30) and Ruben McLain (46), both of Winston Salem, North Carolina, have pleaded guilty to conspiracy to commit healthcare fraud. Each faces a maximum penalty of five years in prison and a fine of up to $250,000. A sentencing date has not yet been set.
According to the plea agreements, Thorpe and McLain agreed that McLain was an “excluded provider” – meaning that he was prohibited from billing the federal health care programs for any services. McLain had been excluded from participation in these programs due to an earlier 2011 federal conviction for health care fraud.
Notwithstanding this exclusion, Thorpe and McLain together worked to create and manage Coastal Bay, a company that provided medical care to Medicaid patients. Thorpe never disclosed to the Medicaid program that he was working with an individual who had been excluded from participating in the program. In an effort to conceal McLain’s involvement, McLain used an alias – “Julian Winchester.” Through this alias, McLain performed a variety of functions, including hiring and firing individuals, seeing patients, and performing other managerial tasks. McLain routinely traveled from his home in North Carolina, to Jacksonville, to assist in Coastal Bay’s operations.
McLain and his family received significant financial benefits due to his involvement in Coastal Bay. Specifically, McLain had access to a Coastal Bay credit card, which he used to make routine purchases at restaurants, furniture stores, gas stations, and other places in North Carolina, even though Coastal Bay had no operations in North Carolina. In addition, McLain and his immediate family received more than $10,000 in direct payment withdrawals from the Coastal Bay business account.
This matter was investigated by the U.S. Department of Health and Human Services and the State of Florida Medicaid Fraud Control Unit. It is being prosecuted by Assistant United States Attorney Jason Mehta and Jay Taylor.