Local News

Nine health providers charged with Medicaid fraud

Posted December 18, 2012

— Nine health care providers in five North Carolina counties were charged Tuesday in the state’s continuing crackdown on Medicaid fraud, authorities said.

The suspects – a dentist, home health care workers, a mental health care provider and an HIV case manager – are accused in various schemes that netted about $200,000 in fraudulent payments, according to Attorney General Roy Cooper.

State Bureau of Investigation agents made the arrests in Wake, Cumberland, Dare, Alleghany and Sampson counties, and authorities said more were expected in the coming weeks.

A Medicaid fraud sweep last December resulted in 20 arrests. Seventeen of those suspects have been convicted, and two more are awaiting trial.

“We’re continuing our crackdown to deter those who would commit health care fraud,” Cooper said. “Cheating Medicaid is illegal, and our investigators and attorneys are finding violators and making them pay.”

The suspects arrested Tuesday include:

Gloria Sawyer, HIV case manager, Wake County. Sawyer, owner of I Believe in Miracles, is accused of concealing her felony drug convictions when she applied to be a state Medicaid provider. Authorities said she received more than $100,000 for her services to Medicaid recipients. Sawyer is charged with three counts of obtaining property by false pretenses and two counts of obtaining property by false pretense.

Kellie Hickman, home health care aide, Sampson County. Hickman is accused of submitting false timesheets for care she did not provide to two Medicaid recipients while she worked for United Home Care Inc. The state estimates the loss at $2,932.50, which United Home Care Inc. has already reimbursed. Hickman is charged with two counts of medical assistance provider fraud.

Dr. Francis Bald, dentist, Dare County. Bald, who owns practices in Nags Head and Elizabeth City, is accused of billing Medicaid for extra dental procedures he didn’t perform or were unnecessary. The state estimates the loss at more than $3,180. Bald is charged with medical assistance provider fraud and obtaining property by false pretenses.

James Tillman, mental health provider, Cumberland County. Tillman is accused of falsely representing his educational qualifications in order to provide mental health services. Authorities said he wrongly received more than $74,000 in Medicaid payments for his services. He is charged with three counts of medical assistance provider fraud, three counts of obtaining property by false pretenses and two counts of falsifying documents issued by a postsecondary education institution.

Deborah Aroche, Tammy Atkins, Michelle Bottomly, Jessica Cook, Amy Lyall, home health care aides, Alleghany County. The women, who were employees of Families First Home Health Care, are accused of submitted false timesheets for personal care services they did not provided. The state estimates the loss at more than $21,000. They are each charged with medical assistance provider fraud.

The Attorney General’s Medicaid Investigation Division nearly doubled in size last year to take on more cases. The team of attorneys, investigators, crime analysts and support staff investigate fraud and abuse of Medicaid benefits by patients, health care providers, pharmaceutical companies, ambulance services and others.

Cooper said the division has recouped more than $500 million in the past decade and secured convictions for hundreds of suspects.
 

35 Comments

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  • weasel2 Dec 19, 3:50 p.m.

    Its a start lets see how many more are out there. Great Job!!

  • jacksun48 Dec 19, 1:54 p.m.

    Publish their pictures in the local newspapers and show them on the internet on a state website titled "North Carolina citizens that are stealing from you by corrupting our government efforts to help each other". Then send them to prison for 5 years or more and get the money back from them somehow.

  • MariAnn Dec 19, 12:04 p.m.

    Agree with ProzacDispenser--small potatoes. Medicaide does not send statements to clients. I'm sure if clients knew what was being paid in their behalf many more "errors" and "fraud" could be found.

  • Rebelyell55 Dec 19, 9:29 a.m.

    I know a woman who claims her husband has abandoned her so she can get Medicaid..but he is there.. every night. Oh, I called people. They have done nothing. It is the whole system that stinks.

    peppercorns
    December 18, 2012 5:54 p.m.....................................
    I've heard this pretty common and that Social Service really don't have anyway to disprove it. They're not allowed to question the nationality of a person. They also not allowed to question if someone is here legally or not.

  • dontgetmestarted Dec 19, 9:25 a.m.

    Rachel....I like you. :)) Couldn't have said it better. BUT, you know as well as I do we are considered uncaring, selfish and VERY politicaly incorrect to recongnize and actually speak the truth. Sad thing is people don't view children as the very thing they are...a blessing and a privelage to have NOT a human rights issue. When you have children you have been blessed and are personally put in charge of that child's wellfare and wellbeing by the One who created them. If you didn't plan to have that child either own up to the responsibility of your actions or make arrangements for that child with someone who will and make sure you don't make the same "mistake" twice. NO excuses for having multiple children if you can't afford them. Period. Unfortunate things happen but public ASSISTANCE should be just that, assistance while YOU make arrangements to put yourself in a better place unless you are truely and completely unable to do so which should be the exception not the rule.

  • Crumps Br0ther Dec 19, 8:27 a.m.

    INSTREST OR PROVIDE FUNDING TO COPORATE C.E.O.'S IN THE FORM OF BONUES THANK YOU
    pbjbeach

    USING ALL CAPS MAKE ME FEEL POWERFUL TOO! If you're going to flame someone show a little etiquette

  • same ole story Dec 19, 8:18 a.m.

    Lets see the pictures of these criminals. The police department must have these crooks on file by now. I want to see who is stealing our money that needs to be put to good use!!!

  • driverkid3 Dec 19, 8:18 a.m.

    rachel, you nailed it. I was going to ask the same thing, but you did a better job of it than I could. Thanks!

  • COLT45 Dec 19, 8:08 a.m.

    Bust them all and give them the maximum penalty. Make examples of them, bring in the media cameras. Maybe other criminials like this will get the message.

  • autismawareness Dec 19, 8:06 a.m.

    I know a woman who claims her husband has abandoned her so she can get Medicaid..but he is there.. every night. Oh, I called people. They have done nothing. It is the whole system that stinks.
    peppercorns

    just like the IRS, try to report a tax cheat & they don't care unless it involves a $million+.

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