Six Charged In Health Care Fraud Scheme Targeting Medicaid
Network of Conspirators Submitted $10 Million in Fraudulent Claims & Falsified Documents to Support the Sham Services
CHARLOTTE, N.C. – Six members of a health care fraud ring that targeted Medicaid by submitting approximately $10 million in fraudulent reimbursement claims have been charged with health care fraud conspiracy, announced Jill Westmoreland Rose, Acting U.S. Attorney for the Western District of North Carolina.
Filed criminal bills of information charge Wanda Marie Webb, 65, and Lachanda Clotier Parks, 40, both of Charlotte; Alexander Bass, 41, and Torrey Darnell Moton, 44, both of Fuquay-Varina, N.C.; Jacqueline Priscilla Ford, 34, of Fayetteville, N.C; and D’Marcus Antonio White, 25, of Baton Rouge, Louisiana with one count of health care fraud conspiracy. Webb and Ford pleaded guilty in Court earlier today. Parks, Moton, Bass and White previously entered their guilty pleas.
Acting U.S. Attorney Rose is joined in making today’s announcement by John A. Strong, Special Agent in Charge of the Federal Bureau of Investigation (FBI), Charlotte Division.
According to filed court documents, admissions reflected in the filed plea agreements and statements made in court, at various times between October 2012 and August 2013, unindicted conspirators #1 (CC#1) and #2 (CC#2) conspired with Webb, Parks, Bass, Moton, Ford and White to defraud Medicaid by filing false claims for payment for mental and behavioral health services to Medicaid recipients which were never actually provided. According to court records, the network of conspirators executed the fraud through a number of mental and behavioral health services companies, including “United Rehabilitation Services” (URS) in Erwin, N.C., which was owned and operated by Bass and Moton.
Court records show that Bass and Moton agreed to pay CC#1 $4,000 per month in exchange for coordinating the filing of fraudulent claims to Medicaid on behalf of URS. At the direction of CC#1, Bass and Moton also paid CC#2, who operated as the scheme’s patient-recruiter, to collect Medicaid beneficiary numbers which were then used to file the false claims. Court records indicate that between January and July 2013, CC#1, Bass and Moton filed over $1.1 million in fraudulent claims, and Medicaid paid out approximately $400,000 directly to Bass and Moton.
According to plea documents and other court filings, the network of conspirators generated fake documents to support the fraudulent claims and in case Medicaid ever audited the providers for the claimed services. White, Ford and Parks generated fictitious paperwork, which included fake intake sessions, fake clinical assessments and fabricated therapy notes. At the direction of CC#1, White’s role, among other things, was to organize on spreadsheets the information of the non-existent mental health problems and treatment plans for the Medicaid recipients, to reflect which fake services were allegedly rendered to each recipient, court records show.
Court records also indicate that during the relevant time period, Webb, a licensed and Medicaid-approved psychologist, agreed to allow CC#1 to use her Medicaid provider number to submit the fraudulent reimbursement claims, listing Webb as the attending clinician. Court records show that Webb kept approximately 68% of the Medicaid reimbursements, and paid 25% to CC#1 and 7% to other individuals responsible for processing the fake claims. According to court records, just in the month of August 2013, using Webb’s Medicaid provider number, the conspirators submitted approximately $239,175 in false claims, of which $79,338.74 was paid out to Webb directly.
The health care fraud conspiracy charge carries a maximum sentence of 10 years in prison and a $250,000 fine.
The investigation, which is ongoing, is being handled by the FBI with assistance from the North Carolina Medicaid Investigations Division. Assistant U.S. Attorney Kelli Ferry is in charge of the prosecution.
Four other defendants previously admitted to their involvement in the Medicaid fraud scheme. In late 2014, Aliya Boss, Zaria Davis Humphreys, Kino Williams and Sakeenah Davis each pleaded guilty to one count of health care fraud conspiracy and currently await sentencing. (Please visit: http://www.justice.gov/usao-wdnc/pr/charlotte-woman-pleads-guilty-conspiracy-defraud-medicaid-more-43-million to view WDNC’s press release related to those prosecutions).
The investigation and charges are the work of the Western District’s joint Health Care Fraud Task Force. The Task Force is multi-agency team of experienced federal and state investigators, working in conjunction with criminal and civil Assistant United States Attorneys, dedicated to identifying and prosecuting those who defraud the health care system, and reducing the potential for health care fraud in the future. The Task Force focuses on the coordination of cases, information sharing, identification of trends in health care fraud throughout the region, staffing of all whistle blower complaints, and the creation of investigative teams so that individual agencies may focus their unique areas of expertise on investigations. The Task Force builds upon existing partnerships between the agencies and its work reflects a heightened effort to reduce fraud and recover taxpayer dollars.
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. To report Medicaid fraud in North Carolina, call the North Carolina Medicaid Investigations Division at 919-881-2320.