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Medicaid fraud sweep nets 18 NC providers

Posted December 19, 2011
Updated February 3, 2015

EDITOR'S NOTE: Court documents show all four charges against Andora Hailey were dropped on Dec. 2, 2013, because the state had insufficient evidence to warrant prosecution.


RALEIGH, N.C. — North Carolina authorities have arrested 18 health care providers accused of defrauding the state Medicaid system, Attorney General Roy Cooper said Monday.

The charges allege more than $500,000 in fraudulent payments combined. The state is pursing criminal convictions as well as restitution of money from the accused, Cooper said.

“Ripping off Medicaid hurts needy patients, wastes taxpayer money and drives up health care costs,” he said in a statement. “We’re sending a strong signal to those who defraud Medicaid that we will find you and make you pay.”

Those arrested include the following:

  • Andora Hailey, a Wake County mental health provider, is charged with four counts of Medicaid provider fraud. Investigators allege that she submitted more than $25,000 in bogus time sheets for payment.
  • Sarina Hotka, operator of a Cumberland County health care agency, is charged with eight counts of Medicaid provider fraud. Investigators allege that she billed the Medicaid program for more than $150,000 in unauthorized personal care services.
  • Gloria Rogers, a Cumberland County speech therapist, is charged with seven counts of Medicaid provider fraud. Investigators allege that she billed the Medicaid program for more than $50,000 in services she wasn't licensed to provide.
  • Cynthia Denise McLean, operator of a Harnett County home health care agency, is charged with three counts of Medicaid provider fraud. Investigators allege that she submitted more than $8,000 in bogus time sheets for payment.
  • Geralyn Brown, operator of a Robeson County home health care agency, is charged with two counts of Medicaid provider fraud. Investigators allege that she submitted more than $1,000 in bogus time sheets for payment.
  • Timothy Batts, operator of a Wayne County group home, is charged with five counts of Medicaid provider fraud. Investigators allege that he billed the Medicaid program for more than $20,000 in unauthorized services at his group home and billed for services to Medicaid recipients that were not provided.

More arrests expected in the weeks and months ahead, Cooper said.

The Medicaid Investigation Unit in the Attorney General’s Office has nearly doubled in size since last year with the addition of new attorneys, investigators, criminal information analysts and support staff, making such crackdowns possible, he said.

“Our investigators, agents and prosecutors are working harder and smarter than ever before to go after Medicaid cheaters and stop the fraud,” he said.

40 Comments

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  • missdejavu9482 Dec 22, 2011

    Keith- there are so many professionals that have left Port for the exact reasons. They keep clients on Methadone for years, have unqualified ppl doing things that only a licensed person should do. Not sure why the State doesn't take the complaints serious. I guess the clowns running it have a lot of people on their side. People come in to aduit the place and stay an hour while other Agencies get combed through. That places cares NOTHING for clients just money ironic how they are non-profit lol. To think they are controlling much of eastern NC as a provider. What is done in the dark will come to light one day.

  • cblackman Dec 21, 2011

    My daughter works for an agency in Dunn/Benson. Was told by this owner yesterday that when she get paid on 12/30 will only be for one week worked instead of two. The next pay 1/13 MIGHT be for two weeks and the week she's owed, but no promise. Yet, if she refuses to work for free, then her clients suffer. The families should be made aware of this. She says Medicaid isn't paying. That's no true. Medicaid has a set checkwrite schedule every year. So, there are definitely other problems. Maybe this company is one of these with fraud problems? Maybe will file bankruptcy and no one get paid? Who knows.

  • keitht4e Dec 20, 2011

    PORT is the worst of the worst. The clowns that run that place have lost touch. They place kids on methadone who haven't used opiods in weeks. The stories I could tell you from having worked there.

  • keitht4e Dec 20, 2011

    I worked at PORT and you are right. The doctrine I live by is "above all else do no harm." PORT Human Services could care less about that. They were putting people on Methadone who were asking for detox because they know they will have them hooked for years. I would do assessements and they wouls say "don't sign it, a liscenced person needs to sign it." Pretty sure that is illegal.

  • danceshare43 Dec 20, 2011

    "If those that are in charge of Medicaid were in charge and had a system of checks and balances, maybe things would not happen as this."

    ljohnson, on the contrary, there is a large branch of Medicaid solely devoted to fraud and abuse--finding, investingating, and prosecuting--known as Program Integrity. They were the folks who discovered the providers in this story, and recoup millions of dollars every year as well as advise policymakers to add checks and balances to prevent future fraud.

  • missdejavu9482 Dec 20, 2011

    They need to look into Port Human Services one of the largest agencies in eastern NC, Greenville. So much fraud (medicaid, insurance, IRPS, grants etc) many of the multiple locations. Many people in the community know about their practices yet they are "untouchable" have many county and state people on their side who look past the problems.

  • driverkid3 Dec 20, 2011

    Now, they need to go after people that lie and cheat to get medicaid and other benefits and lock them up too.

  • whatusay Dec 20, 2011

    Only 18 ????

  • ljohnson247 Dec 20, 2011

    If those that are in charge of Medicaid were in charge and had a system of checks and balances, maybe things would not happen as this. But, like many governmnet angencies, pay out the money and ask questions next year. Get the money back, good luck. It been long spent. More time and money is being used after the fact than before the fact. Is not something wrong here. People are put in charge of things only because they helped someone get in the big house not what they know or can do.

  • unc70 Dec 19, 2011

    citizensoldier,

    In your ER story, what part of that do you think is fraud? What you describe is part our completely screwed up system of government, our tendency to see others as undeserving, of blaming the victim, ...

    The profit for insurance companies, the value as election issues, the distraction from real solutions -- these come by distorting reality on all sides to keep us angry at and fighting with each other.

    We should know better. Our families did their best.

    When every one has enough, anyone can have more.

    "Let everyone go through the line, then you can go back for seconds."

    The hungry, the sick, the weak among us.

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