Mount Pleasant Speech Therapist Sentenced to Over 9 Years in Federal Prison for Health Care Fraud and Aggravated Identity Theft
Charleston, South Carolina---- United States Attorney Sherri A. Lydon announced today that Gena Randolph, 44, of Mount Pleasant, South Carolina, was sentenced to over 9 years in federal prison for executing a health care fraud scheme over the course of almost five years.
Randolph’s sentence comes after a four-day trial in July prosecuted jointly by the United States Attorney’s Office and the South Carolina Attorney General’s Office. A federal jury convicted Randolph of executing a health care fraud scheme totaling almost $2 million. Randolph was convicted of one count of Health Care Fraud, one count of Aggravated Identity Theft, and three counts of Making False Statements Relating to Health Care Matters.
According to evidence presented at trial, Randolph was excluded from Medicare and Medicaid after her 2012 conviction for Filing False Claims with the South Carolina Medicaid Program. As an excluded person, she was prohibited from working for any provider to perform services paid for, in whole or in part, by Medicare and Medicaid.
From 2012 to 2017, Randolph disguised her ownership and control over Palmetto Speech and Language Associates and Per Diem Healthcare Services, both of which were submitting claims to Medicare and Medicaid. As part of the health care fraud scheme, Randolph submitted claims both for speech therapy services that were provided by other speech therapists and for services that were never rendered at all. The jury was also presented with evidence showing that Randolph submitted claims for services to beneficiaries who were dead.
United States District Judge Richard M. Gergel presided over the trial and sentenced Randolph to 111 months in federal prison. There is no parole in the federal system, and her prison sentence will be followed by three years of court-ordered supervision. Randolph was also ordered to pay $580,937.44 in restitution.
“This case should serve as a warning sign to health care providers tempted try to take advantage of the size of our health care system, hoping that false and fraudulent claims will go unnoticed among the thousands of claims processed every day,” said U.S. Attorney Lydon. “When providers like Ms. Randolph break the rules, American taxpayers are forced to bear the cost. Her sentence will help recover that cost and discourage fraudulent billing by other providers in the future. We applaud the vigilant employees who spotted Ms. Randolph’s fraud and were brave enough to report it to law enforcement, as well as the hard work of our partners at the Attorney General’s Office and the Department of Health and Human Services.”
South Carolina Attorney General Alan Wilson stated, “This wasn’t just fraud, it was an attack on the people of the state because she took taxpayers’ money that was meant for health care after having already been convicted of a previous fraud. I’m thankful that the hard work by our Medicaid Provider Fraud Unit, the U.S. Attorney’s Office and the Department of Health and Human Services paid off in restitution and a long prison sentence.”
The case was investigated by Special Investigator Chris Radcliff of the Medicaid Fraud Control Unit of the South Carolina Attorney General’s Office and Special Agent Chris Lott with the United States Department of Health and Human Services – Office of Inspector General. The case was prosecuted by Nancy Cote, Senior Assistant Deputy Attorney General and Director of the Medicaid Fraud Control Unit, and Assistant United States Attorneys Matt Austin and Sean Kittrell of the Charleston office.