Tag: Fraud

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The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

[MM Curator Summary]: Craig Lovelace stole $11.4M using a broad-reaching DME scheme.

 
 

 
 

Clipped from: https://www.justice.gov/usao-edla/pr/destrehan-man-pleads-guilty-114-million-medicare-and-medicaid-fraud-scheme

NEW ORLEANS, LOUISIANA –  CRAIG L. LOVELACE, age 53, a resident of Destrehan, pled guilty to defrauding Medicare and Medicaid of approximately $11.4 million in medically unnecessary durable medical equipment (“DME”), announced U.S. Attorney Duane A. Evans.

The government filed a bill of information charging LOVELACE with healthcare fraud, in violation of Title 18, United States Code, Section 1347. According to court documents, from approximately January 2016 through June 2022, LOVELACE, through his company Advanced Medical Equipment Inc., billed Medicare and Medicaid for durable medical equipment (“DME”) that was medically unnecessary. That included equipment for respiratory support and nutritional support, including ventilators, tracheostomy supplies, and feeding tubes. In reality, those items were medically unnecessary, not ordered, or not provided as represented.  In some instances, the patients had already died. LOVELACE billed Medicare and Medicaid approximately $11.4 million in connection with this scheme, and his company was reimbursed over $7.9 million. To cover up his scheme, LOVELACE directed the falsification of documents, including medical records, order forms, and supporting documentation, in response to Medicare audits and record requests. The falsification of documents included forging provider signatures, medical notes, and dates, as well as using tape, white-out, and scissors, to make it falsely appear that the audited DME was ordered and delivered.

LOVELACE faces up to ten years in prison. LOVELACE also faces up to three years of supervised release after release from prison, a fine of up to $250,000 or twice the gross gain to LOVELACE or the gross loss to any victims, and a mandatory $100 special assessment fee.

U.S. District Judge Jane Triche Milazzo set the sentencing hearing for November 29, 2023.

U.S. Attorney Evans praised the work of the Health and Human Services Office of Inspector General and the Louisiana Medicaid Fraud Control Unit. U.S. Department of Justice Trial Attorneys Kelly Walters and Samantha Stagias of the Criminal Division’s Fraud Section and Assistant U.S. Attorney Nicholas Moses, Health Care Coordinator for the Eastern District of Louisiana, are prosecuting the case.

MM Curator summary

The article below has been highlighted and summarized by our research team. It is provided here for member convenience as part of our Curator service.

 
 

[MM Curator Summary]: Manjit and Gurmej lied about their income and ended up getting $315k in Medicaid-covered services.

 
 

 
 

Clipped from: https://www.supertalk.fm/mississippi-couple-to-pay-over-315k-after-submitting-false-medicaid-forms/

 
 

Two individuals are having to pay $315,380 for falsifying their income to unlawfully create eligibility for Mississippi Medicaid health care benefits for their dependents.

 
 

Manjit Kaur and Gurmej Singh reportedly received Medicaid benefits for their dependents despite not meeting low-income requirements. Kaur and Singh, a husband-wife duo, collectively owned and/or were associated with at least 15 convenience stores, gas stations, and wine stores located in Mississippi.

The two intentionally omitted their multiple businesses from health benefit applications. Kaur and Singh also own an 8,804-square-foot home located in Madison, which was most recently valued at $2.25 million.

Despite having these assets, the two represented on numerous Mississippi Medicaid healthcare benefit applications and renewals that Kaur was the sole source of income from one business receiving approximately $1,500 per month.

In addition, it was falsely documented that Singh was not residing in the home or contributing to the household income. As such, prosecutors allege that from January 1, 2016, to December 22, 2022, Kaur and Singh caused the Mississippi Division of Medicaid (MDOM) to pay $157,690 in federal healthcare coverage benefits on behalf of ineligible recipients.

“The Medicaid Program is intended to provide access to quality health coverage for our most vulnerable populations in Mississippi,” U.S. Attorney Darren LaMarca said. “Our office is committed to uncovering individual fraudsters and protecting the funding for eligible Mississippians and their families.”

The Medicaid program is a state and federally-funded health benefits program intended to assist low-income individuals and families. MDOM is the single state agency responsible for administering these healthcare benefits for those eligible.

This case was investigated by the U.S. Department of Health and Human Services, Office of the Inspector General, and supported by the MDOM and the Mississippi Attorney General’s Office’s Medicaid Fraud Control Unit.

Stay up to date with all of Mississippi’s latest news by signing up for our free newsletter here. 

Copyright 2023 SuperTalk Mississippi Media. All rights reserved.

MM Curator summary

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[MM Curator Summary]: Abdoulie Lowe stole about $800k of your tax dollars using bogus Medicaid claims.

 
 

 
 

Clipped from: https://alaskapublic.org/2023/08/04/anchorage-assisted-living-home-operator-charged-in-medicaid-fraud-case/

 
 

A sign directs visitors to either the Nesbett Courthouse or Boney Courthouse in downtown Anchorage. (Valerie Kern/ Alaska Public Media)

An Anchorage man is accused of fraudulently collecting nearly $800,000 in Medicaid payments over the past two years, state officials said Thursday.

According to a statement from the Alaska Department of Law, a grand jury indicted 47-year-old Abdoulie Lowe for receiving reimbursements for work which wasn’t documented as required by law. He also allegedly submitted another $7,000 in claims for services he claimed to provide to people in his care “when he was actually working elsewhere,” the statement said. 

An initial indictment in the case listed offenses spanning from October 2021 through April of this year. Lowe – who did business as Apapa Assisted Living Home – allegedly submitted more than $328,000 in fraudulent claims for care of a single patient, plus more than $248,000, $185,000 and $32,000 for three others.

Maeve Kendall, the assistant attorney general with the state Medicaid Fraud Control Unit prosecuting the case against Lowe, declined to discuss the developing case in detail Friday. She said none of the money has been recovered yet, in what she called one of the unit’s larger cases.

“A six-figure fraud is certainly a significant matter for our unit, and especially in Alaska,” Kendall said.

According to Kendall, Apapa had been providing care at an East Anchorage apartment, an arrangement she said was relatively common for small assisted-living facilities in Alaska.

“At the arraignment yesterday, Mr. Lowe did confirm with the court that he is no longer operating as a Medicaid provider,” Kendall said. “So he does not have clients in his care at this point.”

Lowe could not be reached for comment Friday. Court records didn’t list a lawyer for him.  A phone number for Apapa Assisted Living had been disconnected.

Lowe is charged with six felony counts of medical assistance fraud and one felony count of second-degree theft, plus failing to maintain workers’ compensation for his employees.

According to the Department of Law, the most severe charges against Lowe carry penalties of up to 10 years in prison, a $100,000 fine and payment of restitution to the state.

“A conviction on any of these charges can lead to Mr. Lowe’s exclusion from the Medicaid program,” prosecutors wrote.

MM Curator summary

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[MM Curator Summary]: The NC lab stole $2M in bogus Medicaid claims for urine drug tests.

 
 

Clipped from: https://ncdoj.gov/attorney-general-josh-stein-announces-1-9-million-medicaid-settlement-with-cary-lab/

 
 

For Immediate Release:
Friday, August 4, 2023

Contact: Nazneen Ahmed
919-716-0060

(RALEIGH) Attorney General Josh Stein today announced that Aspirar Medical Lab LLC in Cary and its owner Pick Chay have agreed to pay $1,951,090 to resolve allegations that they violated the law by billing the North Carolina Medicaid program for unnecessary urine drug tests and paying illegal kickbacks for these tests.

“My office will hold accountable health care companies that waste money intended to improve the health of North Carolinians,” said Attorney General Josh Stein. “I’m grateful for the state and federal partnership to protect taxpayers.”

Aspirar allegedly paid two companies for each urine drug test that they referred to Aspirar. It was also alleged that these tests were medically unnecessary where they were not patient-specific and did not reflect an appropriate determination of the patient’s need for the test. Aspirar submitted these clams to Medicaid from March 2016 to September 2017.

The investigation and prosecution of this case was conducted in partnership with the U.S. Attorney’s Office for the Western District of North Carolina, the FBI in Charlotte, and the Office of Inspector General of the U.S. Department of Health and Human Services.

About the Medicaid Investigations Division (MID)

The Attorney General’s MID investigates and prosecutes health care providers that defraud the Medicaid program, patient abuse of Medicaid recipients, patient abuse of any patient in facilities that receive Medicaid funding, and misappropriation of any patients’ private funds in nursing homes that receive Medicaid funding.

To date, the MID has recovered more than $1 billion in restitution and penalties for North Carolina. To report Medicaid fraud or patient abuse in North Carolina, call the MID at 919-881-2320. The MID receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award totaling $6,106,236 for Federal fiscal year (FY) 2022. The remaining 25 percent, totaling $2,035,412 for FY 2022, is funded by the State of North Carolina.

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MM Curator summary

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[MM Curator Summary]: The state’s largest psychiatric facility is refusing to comply with auditor requests for information after it pivoted most of its billings to a single, higher-paying code.

 
 

 
 

Clipped from: https://www.sevendaysvt.com/vermont/attorney-general-investigating-brattleboro-retreat-for-medicaid-fraud/Content?oid=38814711

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The Vermont Attorney General’s Office is investigating the Brattleboro Retreat for potentially defrauding the state.

The probe centers around whether the Retreat violated the Vermont False Claims Act by billing Medicaid for services it never provided. Investigators say they have evidence suggesting that the Retreat may have engaged in an illegal billing practice known as “upcoding,” in which providers overstate the severity of a patient’s illness to receive a higher payment.

The investigation has been under way since 2020 but quietly spilled into public view last week. The AG’s Office filed a petition in court seeking to force the nonprofit hospital to comply with a detailed request for information, known as a civil investigative demand, that it sent in June.

Investigators say the Retreat has refused to comply without legal justification.

“If the False Claims Act is to serve any purpose in interdicting suspected fraud, The Retreat cannot be permitted to stall — or worse yet, evade — an explicit, authorized and relevant State investigative demand,” assistant attorney general Douglas Keehn wrote in a court filing this week. The AG’s Office declined to comment on the matter.

The Retreat refused an interview request and declined to comment on the investigation. But in a statement, a spokesperson said state investigators were seeking documents beyond the scope of their authority.

“Like all hospitals, the Retreat is subject to various audits and reviews, and we look forward to continuing to collaborate with the attorney general’s office in its important oversight function,” the statement read.

The Brattleboro Retreat is Vermont’s largest psychiatric hospital, providing both addiction and mental health inpatient treatment. It has been on shaky financial ground for years, which leaders have blamed in part on the state’s reluctance to raise Medicaid reimbursement rates to keep pace with costs; roughly half of the nonprofit hospital’s revenue comes from Medicaid.
The fraud probe began after the agency that oversees Medicaid — the Department of Vermont Health Access — identified “suspicious” changes to the Retreat’s billing practices, court documents show.

In particular, state investigators found that the Retreat had begun using one specific billing code much more without any explanation. That code, according to court records, results in a “significantly higher” payment than others the hospital once relied on.

The Department of Vermont Health Access reported its findings to the AG’s Office in March 2020. A Seven Days records request for that report was denied on the basis that it could “interfere with enforcement proceedings.”

The report prompted the AG’s Medicaid Fraud & Residential Abuse Unit to subpoena the hospital for documents related to its billing practices.

A review of more than 50,000 pages of material showed that the hospital had “frequently” submitted billing codes that were unsupported by the patient’s diagnosis and treatment, according to the recent court filing. Investigators also found emails referencing pertinent documents that the hospital did not fork over.

The AG’s Office spent a year trying to schedule a meeting with the Retreat’s leadership, the filing says. When the two sides finally met in March 2022, investigators laid out their most concerning findings and requested the still-outstanding documents.

“From that date forward, other than nonspecific assurances of cooperation and requests to repeat information already provided, The Retreat has not provided any substantive response, document or witness,” the filing says.

The hospital has already been the subject of one major state probe in the last decade.

In 2013, then-attorney general Bill Sorrell began investigating whistleblower claims that the Retreat had committed Medicaid fraud. Two years later, Auditor Doug Hoffer recommended the state expand the scope of its investigation.

The probe concluded in 2018, when Sorrell’s successor, T.J. Donovan, announced that while the hospital was deficient in “several areas” of its billing practices, none appeared to have financially harmed the state.

The hospital agreed to hire a third party to review its billing procedures and outline recommendations. Asked on Friday whether those steps were ever accomplished, a spokesperson declined comment.

MM Curator summary

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[MM Curator Summary]: Lots of painful, unnecessary procedures done on Medicaid patients in CA and OR. You paid $11.4M to make it happen.

 
 

https://www.fiercebiotech.com/medtech/pain-clinic-chain-pay-114m-settle-medicare-and-medicaid-fraud-claims

 
 

 
 

SACRAMENTO, California—The owner of one of California’s largest chains of pain management clinics has agreed to pay nearly $11.4 million to California, Oregon, and the federal government to settle allegations of Medicare and Medicaid fraud.

The U.S. Department of Justice and the states’ attorneys general say Francis Lagattuta, a physician, and his Lags Medical Centers performed—and billed for—medically unnecessary tests and procedures on thousands of patients over more than five years. It was “a brazen scheme to defraud Medicare and Medicaid of millions of dollars by inflicting unnecessary and painful procedures on patients whom they were supposed to be relieving of pain,” Phillip Talbert, U.S. attorney for the Eastern District of California, said in a statement this month.

The federal Medicare program suspended reimbursements to Lags Medical in June 2020, and Medi-Cal, California’s Medicaid program, followed in May 2021. Lags Medical shut down the same day the state suspended reimbursements. The company, based in Lompoc, California, had more than 30 pain clinics, most of them in the Central Valley and the Central Coast.

A KFF Health News review last year found the abrupt closure left more than 20,000 California patients—mostly working-class people on government-funded insurance—struggling to obtain their medical records or continue receiving pain prescriptions, which often included opioids.

Lagattuta and Lags Medical did not admit liability under the settlement. Lagattuta denied the governments’ claims, saying in a statement he was “pleased” to announce the settlement of a “long-standing billing dispute.” As part of the agreement, Lagattuta will be barred for at least five years from receiving Medicare and Medicaid reimbursements.

“Since the Centers have been closed for a couple of years, it made sense for Dr. Lagattuta to settle the dispute and continue to move forward with his other business interests and practice,” Malcolm Segal, an attorney for Lagattuta and the centers, said in the statement.

According to state officials, the federal government will receive the bulk of the money, about $8.5 million. California will receive about $2.7 million, and an additional $130,000 will go to Oregon. The settlement amount is based in part on Lagattuta’s and Lags Medical’s “ability to pay.” It does not cover the governments’ full losses, which the U.S. attorney’s office in Sacramento said are not public record.

A nearly four-year investigation by federal officials and the California Department of Justice found that from March 2016 through August 2021, Lagattuta and his company submitted reimbursement claims for unneeded skin biopsies, spinal cord stimulation procedures, urine drug tests, and other tests and procedures. Lagattuta began requiring all his clinics to perform various medical procedures on every patient, the officials said, no matter if they were needed or requested by patients’ medical providers. Patients who refused were told they would have their pain medication reduced and could suffer adverse medical consequences.

U.S. and California investigators piggybacked on a federal claim filed in late 2018 by a whistleblower, Steven Capeder, Lags Medical’s former operations and marketing director, who will receive more than $2 million of the settlement.

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MM Curator summary

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[MM Curator Summary]: A group of 6 small-time fraudsters, mostly for bogus personal care attendant claims.

 
 

 
 

https://fortscott.biz/news/ags-medicaid-fraud-unit-recoups-42000-in-restitution

 
 

 
 

TOPEKA – (July 31, 2023) – The Kansas Attorney General’s Medicaid Fraud and Abuse Unit (MFCU) recently prosecuted six Medicaid fraud cases recouping more than $42,600 in restitution from fraudsters, Kansas Attorney General Kris Kobach announced today.

“Our top priority is the protection of crime against one of the most vulnerable groups of our population – the elderly and disabled. These prosecutions should put Medicaid fraudsters on alert. If you hurt Kansas’s most vulnerable, we will prosecute,” said Jackie Williams, First Assistant Attorney General for Kobach’s office.

The AG’s MFCU unit is dedicated to ensuring that Kansas citizens receive the services Medicaid is allocated to provide. The unit investigates and prosecutes Medicaid fraud cases statewide to stamp out corruption and abuse of Medicaid dollars and services.

The unit’s recent cases include the prosecutions of:

• Michelle Kisha Taylor of Shawnee. She pled guilty to making a false claim, statement or representation to the Medicaid Program and unlawful acts concerning computers and was sentenced to 24 months in jail, suspended, and 12 months supervised probation. She was ordered to pay more than $12,000 in restitution to the Kansas Medicaid program for Medicaid fraud. While working another job, Taylor was working as a personal care attendant for her mother, a Medicaid beneficiary. Taylor submitted fraudulent claims for payment to the Medicaid program as if she was providing personal care services to her mother, when in reality, she was working another job or her mother was in the hospital. Taylor’s prosecution was part an “Operation Keeping Them Honest,” a cooperative effort between the attorney general’s office and the U.S. Department of Health and Human Services/Office of Inspector General to investigate fraudulent billing to Medicaid for personal care services provided in Medicaid beneficiaries’ homes. Senior Assistant Attorney General Eve Kemple of Kobach’s office prosecuted the case. She was assisted by analyst Dalton May.
  
• Marquita Francine Standard of Lansing. Standard pled guilty to one count of making a false claim, statement or representation to the Medicaid Program. Standard, a personal care attendant, submitted false claims for payment from Medicaid as if she was providing care to several beneficiaries residing in different locations, all at the same time. Standard was sentenced to six months in the Kansas Department of Corrections, suspended, and 12 months supervised probation. She was ordered to pay $4,093 in restitution. Her case was also part of the “Operation Keeping Them Honest” program. Kemple prosecuted the case with assistance from analyst Sharon Balmain.
  
• Myshia Robertson, 49. Robertson pled guilty to making a false claim to the Medicaid program. She submitted a fraudulent claim to Medicaid for personal care services she did not provide. She was sentenced to nine months in jail, suspended, and 12 months supervised probation. She was ordered to pay $18,200 in restitution – the amount Medicaid lost from her false claims. Assistant Attorney General Debbie Moody of Kobach’s office prosecuted the case with assistance from special agent Natasha Ward, analyst Kim Epps, and nurse investigator Kimberly Smith.
  
• Courtland Edward Allen, 35 of Leavenworth. Allen pled guilty to making a false claim, statement, or representation to the Medicaid program and unlawful acts concerning computers. Allen claimed to be working as a personal care attendant for his brother, a Medicaid beneficiary, when Allen was actually working another job and times when his brother was in school. Allen was sentenced to 24 months in jail, suspended, and 12 months supervised probation. He was ordered to pay $3,687 in restitution. Kemple of Kobach’s office prosecuted the case with assistance from special agent Ward and analyst Epps.
  
• Kevin Matney, 51 of Garnett. In a civil action, Matney was charged with making false claims. He agreed to pay $4,202 in restitution as part of a settlement agreement. Kemple litigated the case. Special Agent Julie Hart, analyst Kimberly Clearwater, and nurse investigator Smith assisted with the case.
  
• Kierra Drinnen, 37 of Sedgwick County. Drinnen confessed to fraud. Drinnen worked as a clinical coordinator nurse in Wichita. While on duty, she stole medication that was paid for by Medicaid for a Medicaid patient. She agreed to a plea deal for that included a sentence of 12 months of jail time, suspended, and 12 months supervised probation. She agreed to continue in substance abuse treatment. Drinnen must pay all court costs in addition to standard conditions of probation. Moody of Kobach’s office handled the case. She was assisted by investigators Kevin Kasl and Smith of the attorney general’s office.
  

To report suspected cases of Medicaid fraud or abuse, please call 1-866-551-6328 or (785) 368-6220 or click here to use our online reporting form.

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CONTACT: Danedri Herbert – (913) 706-6394 danedri.herbert@ag.ks.gov

 
 

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MM Curator summary

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[MM Curator Summary]: Decent-sized DME fraud, mostly for orthopedic equipment made possible by kickbacks to marketers.

 
 

https://www.texasattorneygeneral.gov/news/releases/texas-attorney-generals-medicaid-fraud-control-unit-helps-secure-49-month-sentence-and-over-5Kenric

 
 

 
 

Wakeen Griffin, co-owner of New Horizons Durable Medical Equipment based in Frisco, TX, was sentenced to 49 months of federal incarceration to be followed by a year of supervised release for his role in a medical equipment fraud scheme. In addition, Griffin was ordered to pay $5,114,016.19 in restitution to government health care programs. A jury convicted Griffin of conspiracy to defraud the United States and to pay and receive healthcare kickbacks, as well as seven counts of payment and receipt of kickbacks. 

Griffin obtained patients by offering and paying kickbacks to marketers as well as disguising illegal payments as marketing services and outsourced business services. Griffin then submitted false claims to both Medicaid and Medicare for orthopedic equipment that was never provided, not medically necessary, and not authorized by a physician. 

The investigation was conducted by Sergeant Doug Wood, Investigative Auditor Jennifer Blakely, and Captain Justin Boyce of the Texas Medicaid Fraud Control Unit (“MFCU”) in partnership with the Federal Bureau of Investigation and the U.S. Department of Health and Human Services’ Office of Inspector General. The case was prosecuted by the Department of Justice Health Care Fraud Strike Force. 

The OAG’s Medicaid Fraud Control Unit is dedicated to ensuring that those who exploit our healthcare system for personal gain are brought to justice by aggressively pursuing those who engage in healthcare fraud, working to safeguard taxpayer funds, and defending the integrity of vital healthcare programs. In the last fiscal year alone, the MFCU recovered more than $236 million in settlements and judgments for Texas taxpayers. In Texas, Medicaid costs taxpayers over $40 billion per year. Federal and industry authorities estimate that fraud comprises up to ten percent of the costs of the Medicaid program, making Medicaid fraud a $4 billion problem in Texas.   

The MFCU receives 75 percent of its funding from the U.S. Department of Health and Human Services under a grant award totaling $20,944,200 for fiscal year 2023. The remaining 25 percent, totaling $6,981,395, is funded by the State of Texas. For every dollar of state funding, the OAG’s MFCU recovers more than 33 dollars for taxpayers. If you suspect Medicaid fraud or abuse, or patient neglect, please report it by visiting the OAG’s website. 

 
 

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MM Curator summary

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[MM Curator Summary]: One doc paid 2 other docs to send samples for bogus gonorrhea and chlamydia tests.

 
 

 
 

Clipped from: https://www.wfmj.com/story/49257629/valley-doctor-gets-probation-ordered-to-pay-dollar75k-for-medicaid-and-medicare-kickback-scheme

A Valley doctor has been sentenced for her role in a Medicare and Medicaid kickback scheme.

Dr. Michelle Kapon of Youngstown was sentenced to two-years probation and ordered to pay a $75,000 fine.

According to court documents, Kapon and OBGYN Joni Canby received kickbacks from OBGYN Samir Wahib after sending samples from their patients to him for gonorrhea and chlamydia testing.

Investigators said Wahib would pay Canby $20 and Kapon $15 for every specimen sent his way. Wahib would then allegedly submit claims to the federal government for payment for the tests.

The government claimed the payments were disguised as “physician coverage” on checks from his business.

Between 2014 and 2017, Wahib paid $31,520 to Kapon and Canby over a three-year period.

After pleading guilty, Dr. Kapon cited the influence of the other doctors as a reason for a lenient sentence.

A memorandum filed in U.S. District Court through Kapon’s attorney referred to her relationships with the other two doctors, claiming that Dr. Canby was Kapon’s mentor and became increasingly influential in her life.

“In short, Dr. Canby had become embedded into Dr. Kapon’s life. Dr. Kapon completely trusted Dr. Canby’s judgment. This proved to be misplaced,” attorney Ronald Yarwood wrote.

Yarwood’s memo also claimed that as OB-GYN Department Chair for Northside Hospital, Dr. Wahib had the power to mandate certain requirements on Dr. Kapon, including that she must always have a board-certified OB-GYN available during delivery, and she must always have a call coverage for any patients when she is not available.

The memorandum asked the judge to fine Kapon, sentence her to probation, and order her to pay $37,730 in restitution.

MM Curator summary

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[MM Curator Summary]: They forced tenants in their subsidized housing program to do unnecessary drug tests, and then submitted those tests for payment to Medicaid.

 
 

 
 

https://www.wsoctv.com/news/local/former-charlotte-housing-provider-sentenced-15m-medicaid-fraud-scheme/DQCOAQTGQNF6VJJNOHBI3F4BKA/

 
 

 
 

CHARLOTTE — A 54-year-old Indiana woman was sentenced to 30 months in prison for her role in a $15 million conspiracy to defraud the North Carolina Medicaid program, the U.S. Attorney for the Western District announced Tuesday.

PAST COVERAGE: Federal jury convicts Charlotte man for role in massive healthcare fraud scheme

Jordan will also get three years of supervised release and must pay $5.88 million in restitution.

Jordan was the owner of Legacy Housing, which provided subsidized housing to tenants in Charlotte and Greensboro, according to court documents.

Jordan’s co-conspirator, Donald Booker, owned and operated United Diagnostic Laboratories, a urine toxicology testing laboratory.

 
 

(WSOC)

They also owned and operated United Youth Care Services, which is a company that provided mental health and substance abuse treatment services.

Jordan and Booker conspired with others to defraud Medicaid between January 2018 and December 2020 through a fake drug-testing scheme of urine samples from Medicaid-eligible beneficiaries, according to the U.S. attorney.

Jordan previously admitted in court they recruited housing-vulnerable people and other Medicaid-eligible beneficiaries for housing and other programs and services, the U.S. attorney said.

Once enrolled, the beneficiaries were required to submit urine specimens for drug testing as a condition of the program. The specimens were provided to UDL and UYCS for medically unnecessary urine drug testing, the U.S. attorney said.

Booker and his co-conspirators paid Jordan a kickback from the Medicaid reimbursements on the drug testing. Jordan also conspired with Booker to execute a conspiracy to launder the fraudulent money to conceal and disguise the nature and source of the illegal kickback payments for the illicit drug-testing referrals.

 
 

(WSOC)

On December 9, 2022, Jordan pleaded guilty to healthcare fraud conspiracy and conspiracy to commit money laundering.

In January 2023, Booker was convicted at trial of conspiracy to commit health care fraud, multiple violations of the Anti-Kickback Statute, money laundering conspiracy, and money laundering.

Booker is awaiting sentencing.

©2023 Cox Media Group

 
 

 
 

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