North Carolina Native Is Sentenced To Eight Years For Stealing Millions From Medicaid
For Immediate Release
U.S. Attorney's Office, Western District of North Carolina
Defendant also Spent $2.9 million on an “Opulent Lifestyle” While Evading Income Tax
CHARLOTTE, N.C. – Today, U.S. District Judge Robert J. Conrad Jr. sentenced Tony Garrett Taylor, 40, a native and former resident of Harrisburg, North Carolina, currently residing in Brooklyn, N.Y., to 96 months in prison followed by two years of supervised release, for stealing more than $6.1 million from Medicaid and committing tax evasion, announced Andrew Murray, U.S. Attorney for the Western District of North Carolina. Tony Taylor was also ordered to pay $6,121,655 to North Carolina Medicaid and $1,124,603 to the U.S. Internal Revenue Service as restitution.
John A. Strong, Special Agent in Charge of the Federal Bureau of Investigation (FBI), Charlotte Division, Matthew D. Line, Special Agent in Charge of the Internal Revenue Service, Criminal Investigation Division, Charlotte Field Office (IRS-CI), Tommy D. Coke, Inspector in Charge of the Atlanta Division of the U.S. Postal Inspection Service, which oversees Charlotte, and Attorney General Josh Stein, who oversees the North Carolina Medicaid Investigations Division (MID), join U.S. Attorney Murray in making today’s announcement.
According to filed court documents and today’s sentencing hearing, from June 2015 to December 2017, Tony Taylor and his brother, Jerry Lewis Taylor, operated a scheme to defraud Medicaid of more $9.4 million by submitting false and fraudulent reimbursement claims for patient services that were either non-existent or mischaracterized to Medicaid. The brothers submitted the fraudulent claims through several companies they owned and/or operated, including Taylor Behavioral Health Center, LLC and Options Driven LLC, both located in Monroe, N.C.; Design for Change LLC located in Raleigh and elsewhere; and SHG Consultants, located in Gastonia, N.C. and elsewhere (collectively, the “Taylor businesses”). These entities specialized in providing outpatient behavioral health services to at-risk youth throughout North Carolina.
Court records show that, during the relevant time period, Tony Taylor recruited other co-conspirators to the scheme, including Ameera Ali, who provided billing services for the conspiracy and furnished Tony Taylor with prospective patient lists containing identifying information for eligible Medicaid beneficiaries. The beneficiary information obtained from Ali and others were used, in turn, to file fraudulent reimbursement claims for services that were never provided. To the extent that services were actually provided, the conspirators submitted to Medicaid fraudulent reimbursement claims that misrepresented the services rendered so as to obtain a higher reimbursement rate, a practice known as “upcoding.”
According to court documents, Tony Taylor also recruited Devon Rambert-Hairston, a licensed nurse practitioner and the director of one of the entities operated by the brothers, to review and sign-off on fictitious patient progress notes. Court records show that Rambert-Hairston never provided any behavioral health or medical services to the Medicaid beneficiaries or rarely interacted with them at all. To the extent that the beneficiaries received any treatment, those services were provided by an individual identified in court documents as J.B., who was not credentialed to provide those types of services.
Tony and Jerry Taylor also conspired with Christine Yvette Knight, who operated Connect and Move Staffing LLC in Florida. Knight’s role in the conspiracy was to create fraudulent treatment notes for the beneficiaries, and to prepare fake billing spreadsheets which were used by the brothers to further perpetuate the fraud.
During the course of the fraudulent scheme, Tony and Jerry Taylor caused hundreds of false and fraudulent claims to be submitted to Medicaid for false and fraudulent services. As a result, more than $9.4 million in fraudulent claims were submitted to Medicaid, resulting in approximately $6.1 million in fraudulent payments from Medicaid.
In addition to health care fraud, Tony Taylor also committed tax evasion, by failing to file timely and/or accurate U.S. Individual Income Tax Returns for tax years 2015, 2016, and 2017, and diverting fraudulent receipts from Medicaid to nominee entities and individuals. Tony Taylor also made personal expenditures using business accounts and Medicaid fraud proceeds, including spending more than $2.9 million for his “opulent lifestyle,” air fare, hotels, nightclubs, and shopping.
Tony Taylor pleaded guilty to health care fraud conspiracy and tax evasion. He is currently released on bond and upon designation of a federal facility he will report to the federal Bureau of Prisons to begin serving his sentence.
In announcing Tony Taylor’s sentence, Judge Conrad noted that Tony Taylor stole from programs designed to help disadvantaged children for personal gain and an opulent lifestyle.
Jerry Taylor is currently awaiting sentencing after pleading guilty to health care fraud conspiracy. Ameera Ali also pleaded guilty to health care fraud conspiracy and is currently awaiting sentencing. Devon Rambert-Hairston pleaded guilty to money laundering conspiracy and was sentenced to a year and a day in prison and a year of supervised release, and was ordered to pay $813,726 in restitution. Christine Yvette Knight pleaded guilty to making a false statement relating to health care matters. A sentencing date for Knight has not been set.
In making today’s announcement U.S. Attorney Murray thanked the FBI, the IRS, USPIS, and MID for their investigation of this case.
Assistant U.S. Attorneys Michael Savage and William Bozin of the U.S. Attorney’s Charlotte Office are prosecuting the case.
If you suspect Medicare or Medicaid fraud please report it by phone at 1-800-447-8477 (1-800-HHS-TIPS), or E-Mail at HHSTips@oig.hhs.gov.
Updated April 18, 2023
Health Care Fraud