Last week, the US Department of Justice (DOJ) announced the results of what it described as “the largest ever national healthcare fraud takedown in history.” Of the 324 individuals charged with fraud allegations, 14 were either from or associated with illegal activity in North Carolina. Nine of those 14 were charged within the state of North Carolina, while the remaining individuals were charged in other jurisdictions.
The coordinated nationwide takedown found that the accused illegally distributed over 15 million pills, with $14.6 billion in intended losses — more than double the amount of the prior record of $6 billion. Authorities seized more than $245 million in cash, luxury vehicles, and other assets, according to the DOJ’s press release.
In the press release, US Attorney General Pam Bondi reiterated the federal government’s commitment to appropriately prosecuting those who commit health care fraud.
“Today’s record-setting Health Care Fraud Takedown sends a crystal-clear message to criminal actors, both foreign and domestic, intent on preying upon our most vulnerable citizens and steal from hardworking American taxpayers: we will find you, we will prosecute you, and we will hold you accountable to the fullest extent of the law,” she said.
Bondi noted the effect that these schemes may have on tax paying citizens.
“Make no mistake — this administration will not tolerate criminals who line their pockets with taxpayer dollars while endangering the health and safety of our communities,” she said.
fraud schemes across the carolinas
State and federal officials, including NC Attorney General Jeff Jackson, announced the indictments at a press briefing.
Jackson pointed to a Charlotte resident, Crystal Sherell Jackson, who allegedly submitted more than $1.9 million in fraudulent claims to North Carolina Medicaid. The DOJ reports that Jackson billed for psychotherapy and drug testing services that were never rendered or deemed medically unnecessary.
Additionally, many of the Medicaid identification numbers used in Jackson’s scheme belonged to individuals who were either deceased or incarcerated at the time of billing. According to Jeff Jackson, she falsely claimed to be a licensed health care provider.
In Kinston, a substance abuse treatment company, LifeTouch, LLC, allegedly conducted a scheme involving over $1 million in illegal gift card payments to patients. The inducements allegedly resulted in more than $25 million in Medicaid payments, with staff also receiving kickbacks from a drug testing lab, deceiving auditors. Two of the defendants also face tax-related charges, and authorities have seized over $6 million in assets.
officials react
“Here’s what I want folks who provide Medicaid services to know: we have never had more forensic tools for detecting fraud,” Jackson said at the press briefing.
“If you are committing fraud as a Medicaid provider, you have never been more vulnerable to exposure — and we’re going to find you,” he continued.
US Attorney for the Western District of North Carolina, Russ Ferguson, referred to the high cost of health care in the country.
“Each year, the United States spends $5 trillion on healthcare,” he said.
Ferguson also referenced the importance of partnerships with the many agencies involved in this investigation, thanking each official for their individual efforts.
“We’re all here with one goal — and that is to eradicate health care fraud,” said Ferguson.