Sumter Women Convicted of Healthcare Fraud for Over-Charging Government by Millions of Dollars
Columbia, SC – United States Attorney Sherri A. Lydon announced today that Angela Breitweiser Keith, age 53, and Ann Davis Eldridge, age 58, both of Sumter, South Carolina, pleaded guilty in federal court to one count of false statements to defraud Medicaid.
Evidence presented to the court showed that Keith and Eldridge were executives of the South Carolina Early Autism Project (SCEAP). SCEAP provided behavioral health and education solutions for children and young adults, particularly those diagnosed with autism. SCEAP began providing Applied Behavior Analysis (ABA) services for children with autism in 2003, becoming the number one biller in the country for ABA services by 2015. SCEAP overcharged Medicaid and TRICARE (military-affiliated insurance) millions of dollars by inflating billing records and charging the government for services it did not provide to clients.
SCEAP employees reported to the government that they were pressured to exaggerate the amount of time they spent delivering services to the clients. Company emails indicated that SCEAP encouraged employees to unlawfully bill for time while waiting in driveways, travelling to and from servicing the clients, and even while sitting in restaurants. The employees also indicated that they had required billing goals they had to meet to qualify for job benefits and/or bonuses. These bonuses included gift cards and company-expensed vacations.
Ann Eldridge was a co-founder of SCEAP and Angela Breitweiser Keith worked at the SCEAP since its inception. In December 2012, Eldridge and her partner sold SCEAP to a company called Chancelight for over $18 million. Eldridge and Keith remained with the company, continuing in leadership roles in South Carolina. Chancelight engaged Eldridge to promote the SCEAP system to other Chancelight franchises in the Southeast, and promoted Keith to Senior Vice President of Data Reporting and Analysis.
In 2018, SCEAP/Chancelight repaid the government nearly $9 million for overbilling Medicaid and TRICARE in a civil settlement. Sentencing in the case has not yet been scheduled, but in a plea agreement filed with the court, both Keith and Eldridge have agreed to serve a 12-month federal prison sentence for their role in the fraud.
“We are proud of the excellent work of all the agencies involved,” said U.S. Attorney Lydon. “We take seriously our mission to protect those that are the most vulnerable to this kind of fraud and abuse. These prosecutions, combined with our civil recovery, should serve as a warning to those who seek to unlawfully enrich themselves by stealing from Medicaid or TRICARE and denying services to those with dire needs and those who have bravely served our nation.“
"These guilty pleas are the product of a thorough investigation and demonstrate the commitment of the Defense Criminal Investigative Service (DCIS) and our law enforcement partners to hold dishonest medical service providers accountable when they submit false bills and divert taxpayer funds," said Special Agent in Charge Robert E. Craig, Jr., DCIS Mid-Atlantic Field Office. "DCIS will continue to protect the integrity of the Department of Defense by rooting out fraud, waste, and abuse that negatively impacts critical programs such as TRICARE."
South Carolina Attorney General Alan Wilson stated, “The positive outcome of this case is an example of how valuable it can be for multiple agencies to pool their talents and resources in order to combat fraud. These individuals pleading guilty took advantage of taxpayers’ dollars at the expense of our Medicaid population, some of our most vulnerable. The people of South Carolina deserve better than this, and these convictions show that this behavior will not be tolerated in our state.”
The investigation was conducted by members of the Department of Health and Human Services, Office of Inspector General; the Department of Defense, Office of Inspector General; and the South Carolina Attorney General’s Office. The case is being prosecuted by Assistant United States Attorney T. DeWayne Pearson of the Columbia office.