Jacksonville, FL – Shawn Thorpe (30) and Ruben McLain (46), both of Winston Salem, North Carolina, have been sentenced to prison for their participation in a conspiracy to commit healthcare fraud. Thorpe was sentenced to 2 years’ imprisonment and McLain was sentenced to 4 years and 9 months in federal prison. Thorpe and McLain were also ordered to pay $211,311.20 and $1,159,050.51, respectively, in restitution to their victims.
According to court documents, Thorpe and McLain worked together to create and manage Coastal Bay, a company that provided medical care to Medicaid patients. McLain had been excluded from billing federal healthcare programs based on his 2011 conviction for healthcare fraud. 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 his involvement, McLain used an alias – “Julian Winchester;” he performed a variety of functions, including hiring and firing individuals, seeing patients, and performing other managerial tasks using the alias. McLain routinely traveled to Jacksonville from his home in North Carolina to assist in Coastal Bay’s operations.
McLain and his family received significant financial benefits because of his involvement in Coastal Bay. He had access to a Coastal Bay credit card that 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, he and his immediate family received more than $10,000 in direct payments from the Coastal Bay business account.
This matter was investigated by the U.S. Department of Health and Human Services - Office of Inspector General and the State of Florida Medicaid Fraud Control Unit. It was prosecuted by Assistant United States Attorney Jay Taylor.